Substituted 2-methyl-2-phenoxy-n-propyl-propionamides as cannabinoid receptor antagonists/inverse agonists useful for treating obesity

ABSTRACT

The present invention provides novel substituted 2-methyl-2-phenoxy-N-propyl-propionamides and derivatives thereof that are useful as cannabinoid receptor antagonists/inverse agonists and pharmaceutical compositions thereof and methods of using the same for treating obesity, diabetes, and/or cardiometabolic disorders.

CROSS-REFERENCE TO RELATED APPLICATIONS

The present application claims priority benefit under 35 U.S.C. § 119(e) of U.S. Provisional Patent Application Ser. No. 60/938,844 filed May 18, 2007. The disclosure this application is incorporated herein by reference.

FIELD OF THE INVENTION

The present invention provides novel substituted 2-methyl-2-phenoxy-N-propyl-propionamides and derivatives thereof as cannabinoid receptor antagonists/inverse agonists and pharmaceutical compositions thereof and methods of using the same for treating obesity, diabetes, and/or cardiometabolic disorders.

BACKGROUND OF THE INVENTION

Obesity is associated with an increase in the overall amount of adipose tissue (i.e., body fat), especially adipose tissue localized in the abdominal area. Obesity has reached epidemic proportions in the United States. The prevalence of obesity has steadily increased over the years among all racial and ethnic groups. The most recent data from the Centers for Disease Control and Prevention, and the National Center for Health Statistics report 66% of the adult population overweight (BMI, 25.0-29.9), 31% obese (BMI, 30-39.9), and 5% extremely obese (BMI, ≧40.0). Among children aged 6 through 19 years, 32% are overweight and 17% are obese. This translates to 124 million Americans medically overweight, and 44 million of these deemed obese. Obesity is responsible for more than 300,000 deaths annually, and is one of the leading causes of preventable death in the United States. Obesity is a chronic disease that contributes directly to numerous dangerous co-morbidities, including type 2 diabetes, cardiovascular disease, inflammatory diseases, premature aging, and some forms of cancer. Type 2 diabetes, a serious and life-threatening disorder with growing prevalence in both adult and childhood populations, is currently the 7^(th) leading cause of death in the United States. Since more than 80% of patients with type 2 diabetes are overweight, obesity is the greatest risk factor for developing type 2 diabetes. Increasing clinical evidence indicates that the best way to control type 2 diabetes is to reduce weight.

The most popular over-the counter drugs for the treatment of obesity, phenylpropanolamine and ephedrine, and the most popular prescription drug, fenfluramine, were removed from the marketplace as a result of safety concerns. Drugs currently approved for the long-term treatment of obesity fall into two categories: (a) CNS appetite suppressants such as sibutramine and (b) gut lipase inhibitors such as orlistat. CNS appetite suppressants reduce eating behavior through activation of the ‘satiety center’ in the brain and/or by inhibition of the ‘hunger center’ in the brain. Gut lipase inhibitors reduce the absorption of dietary fat from the gastrointestinal (GI) tract. Although sibutramine and orlistat work through very different mechanisms, they share in common the same overall goal of reducing body weight secondary to reducing the amount of calories that reach the systemic circulation. Unfortunately, these indirect therapies produce only a modest initial weight loss (approximately 5% compared to placebo) that is usually not maintained. After one or two years of treatment, most patients return to or exceed their starting weight. In addition, most approved anti-obesity therapeutics produce undesirable and often dangerous side effects that can complicate treatment and interfere with a patient's quality of life.

The lack of therapeutic effectiveness, coupled with the spiraling obesity epidemic, positions the ‘treatment of obesity’ as one of the largest and most urgent unmet medical needs. There is, therefore, a real and continuing need for the development of improved medications that treat or prevent obesity.

The endocannabinoid system, comprised of the cannabinoid receptors (CB1 and CB2) and their endogenous ligands (e.g., anandamide, 2-AG), plays a prominent role in the control of food intake and energy metabolism. CB1 receptors are widely expressed in the brain, including cortex, hippocampus, amygdala, pituitary and hypothalamus. CB1 receptors have also been identified in numerous peripheral organs and tissues, including thyroid gland, adrenal gland, reproductive organs, adipose tissue, liver, muscle, and gastrointestinal tract. CB2 receptors are localized almost exclusively in immune and blood cells, see Endocrine Reviews 2006, 27, 73.

The plant-derived cannabinoid agonist Δ⁹-tetrahydrocannabinol (Δ⁹-THC), the main psychoactive component of marijuana, binds to both CB1 and CB2 receptors. Δ⁹-THC is widely reported to increase appetite and food intake (hyperphagia) in humans and in animals. This hyperphagic effect is largely blocked by pretreatment with selective CB1 receptor antagonists/inverse agonists [e.g., rimonabant (SR141716A, Acomplia®)], strongly supporting the belief that CB1 receptor activation mediates the hyperphagic effect of Δ⁹-THC, see Endocrine Reviews 2006, 27, 73.

In humans, rimonabant produces a clinically meaningful weight loss in obese patients. Patients also experience improvements in associated cardiometabolic risk factors, including a decrease in triglyceride levels. Rimonabant also produces greater reductions in abdominal fat deposits, which are a known risk factor for diabetes and heart disease. Taken together, these improvements in adiposity and cardiometabolic risk factors produce an overall decrease in the prevalence of the metabolic syndrome, see Lancet 2005, 365, 1389-97 and NEJM 2005, 353, 2121.

The beneficial effects of rimonabant on cardiometabolic risk factors such as high blood pressure and elevated levels of triglycerides cannot be explained by diet and weight loss alone. For example, in patients receiving 20 mg of rimonabant, only approximately 50% of the beneficial effects on triglycerides, fasting insulin, and insulin resistance can be accounted for by weight loss. These results suggest a direct pharmacological effect of CB1 antagonists/inverse agonists on glucose and lipid metabolism, in addition to indirect effects on metabolism secondary to hypophagia-mediated weight loss, see Science 2006, 311, 323 and JAMA 2006, 311, 323.

The CB1 receptor is one of the most abundant and widely distributed G protein-coupled receptors in the mammalian brain. It is believed that the appetite-suppressant properties of CB1 antagonists/inverse agonists are mediated through an interaction with CB1 receptors in the hypothalamus (regulation of food intake), and in the mesolimbic region (rewarding properties of food). However, CB1 receptors are far more broadly distributed in brain (e.g., neocortex, hippocampus, thalamus, cerebellum, and pituitary), and while interacting with targeted CB1 receptors in hypothalamus and mesolimbic regions, CB1 antagonists have ready access to non-targeted CB1 receptors that have little if any role in appetite control. Binding to non-targeted receptors can often lead to unwanted side effects of CNS drugs [Endocrine Reviews 2006, 27: 73]. The CB1 antagonist/inverse agonist rimonabant produces psychiatric and nervous system side effects. These include depressed mood, anxiety, irritability, insomnia, dizziness, and headache. These side effects are dose-related and are most pronounced at the most efficacious weight-reducing dose of rimonabant (JAMA 2006, 311, 323). The occurrence of therapeutic efficacy (appetite suppression) and side effects over the same dose range strongly suggest that both effects are mediated through concurrent antagonism of CB1 receptors in both ‘targeted’ and ‘non-targeted’ brain regions. Brain-penetrant CB1 antagonists do not selectively target CB1 receptors in efficacy brain regions, while ignoring CB1 receptors in side effect brain regions.

The beneficial effects of the CB1 antagonist/inverse agonist rimonabant on body weight, adiposity, diabetes, and cardiometabolic risk factors such as high blood pressure and elevated levels of triglycerides cannot be explained by weight loss derived from CNS-mediated appetite suppression alone, see JAMA 2006, 311, 323. Approximately 50% of the non-CNS benefit is likely derived from an interaction with CB1 receptors in peripheral tissues known to play an active role in metabolism. These include adipose tissue, liver, muscle, and gastrointestinal tract.

In view of the above, it is highly desirable to find effective and highly selective CB1 receptor antagonists/inverse agonists with limited or no CNS adverse side effects, including mood disorders. Particularly, it is desirable to find compounds that preferentially target CB1 receptors in peripheral tissues (e.g., adipose tissue, liver, muscle, and gastrointestinal tract), while sparing CB1 receptors in brain. In this way, peripherally-mediated beneficial effects of CB1 antagonists/inverse agonists should be maintained, whereas CNS side effects should be reduced or eliminated. This should provide a novel opportunity to develop safer agents for the prevention or treatment of obesity, diabetes, and cardiometabolic diseases (e.g., hypertension and dyslipidemias).

SUMMARY OF THE INVENTION

Accordingly, in an aspect, the present invention provides novel substituted 2-methyl-2-phenoxy-N-propyl-propionamides and derivatives thereof or pharmaceutically acceptable salts thereof that are CB1 receptor antagonists.

In another aspect, the present invention provides novel pharmaceutical compositions, comprising: a pharmaceutically acceptable carrier and a therapeutically effective amount of at least one of the compounds of the present invention or a pharmaceutically acceptable salt form thereof.

In another aspect, the present invention provides novel methods for treating obesity, diabetes, and/or cardiometabolic disorders (e.g., hypertension, dyslipidemias), comprising: administering to a patient in need thereof a therapeutically effective amount of at least one of the compounds of the present invention or a pharmaceutically acceptable salt form thereof.

In another aspect, the present invention provides processes for preparing novel compounds.

In another aspect, the present invention provides novel compounds or pharmaceutically acceptable salts for use in therapy.

In another aspect, the present invention provides the use of novel compounds for the manufacture of a medicament for the treatment of obesity, diabetes, and/or cardiometabolic disorders.

These and other objects, which will become apparent during the following detailed description, have been achieved by the inventors' discovery that the presently claimed compounds or pharmaceutically acceptable salt forms thereof are expected to be effective CB1 receptor antagonists/inverse agonists.

DETAILED DESCRIPTION OF THE INVENTION

All references cited herein are hereby incorporated in their entirety herein by reference.

The present invention is based on the finding that a CB1 receptor antagonist has beneficial effects on body weight, adiposity, diabetes, and cardiometabolic risk factors such as high blood pressure and dyslipidemias that cannot be explained by weight loss derived from CNS-mediated appetite suppression alone and that this effect is mediated, at least in part, through interaction at peripheral receptors. To this end, the present invention provides compounds that are designed to preferentially target CB1 receptors in peripheral tissues (e.g., adipose tissue, liver, muscle, and gastrointestinal tract), while sparing CB1 receptors in brain. Peripherally-mediated beneficial effects of CB1 antagonists should be maintained, whereas CNS side effects should be reduced or eliminated.

The compounds of the present invention have been designed to have reduced CNS exposure by virtue of their inability or limited ability to penetrate the blood-brain barrier (BBB) or by their participation in active transport systems, thus reducing centrally mediated side-effects, a potential problem with many anti-obesity agents. It is expected that the peripherally restricted compounds of the present invention will have no or very limited CNS effects. Thus, their peripherally mediated CB1 antagonistic properties should provide therapeutic agents with greater safety, as previously demonstrated in earlier classes of peripherally restricted agents with greater safety.

Moreover, if the maximum dosage of a drug used in the treatment of obesity, diabetes, and/or cardiometabolic disorders (e.g., hypertension, dyslipidemias) is limited as a result of CNS side effects (e.g., seizures, depression, anxiety, movement disorders, and hyperactivity), incorporation of a peripherally restricting group in such a drug would lower the brain concentration of the drug relative to the concentration in the systemic circulation, thereby affording the opportunity to increase the dosage employed to treat the peripheral disorder. The increased dosage may provide greater therapeutic efficacy, as well as a more rapid onset of therapeutic action.

In an embodiment, the present invention provides novel compound AA or a stereoisomer or pharmaceutically acceptable salt thereof:

wherein:

R₁ and R₂ are independently aryl or heteroaryl, wherein each aryl or heteroaryl is substituted with 0-3 substituents independently selected from X and X′;

X and X′ at each occurrence are independently selected from halogen, C₁₋₆ alkyl, CF₃, CN, O—C₁₋₆ alkyl, (CH₂)_(m)tetrazole, O(CH₂)_(n)tetrazole, NRCO₂R, and NRCONR₂;

Y at each occurrence is independently selected from H, halogen, C₁₋₆ alkyl, CF₃, and CN;

Z, Z′, and Z″ are independently N or CY;

Q is selected from H and C₁₋₆ alkyl;

R at each occurrence is independently selected from H and C₁₋₆ alkyl;

m at each occurrence is independently selected from 0, 1, 2, 3, and 4; and,

n at each occurrence is independently selected from 1, 2, 3, and 4;

provided that at least one of Q, X, X′, and Y is suitably modified or replaced by a group capable of reducing or limiting the CNS (brain) levels of compound AA.

[1] In another embodiment, the present invention provides novel compound of Formula I or a stereoisomer or pharmaceutically acceptable salt thereof:

wherein:

R₁ and R₂ are independently aryl or heteroaryl, wherein each aryl or heteroaryl is substituted with 0-3 substituents independently selected from X and X′;

X at each occurrence is independently selected from H, halogen, C₁₋₆ alkyl, CF₃, CN, OC₁₋₆-alkyl, (CH₂)_(m)C(NH)NR₂, O(CH₂)_(n)CO₂R, O(CH₂)_(n)CONR₂, O(CH₂)_(n)C(NH)NR₂, NR(CH₂)_(n)CO₂R, O(CH₂)_(n)C₆H₄(CH₂)_(m)CO₂R, NR(CH₂)_(n)C₆H₄(CH₂)_(m)CO₂R, O(CH₂)_(n)C₆H₄O(CH₂)_(n)CO₂R, NR(CH₂)_(n)C₆H₄O(CH₂)_(n)CO₂R, O(CH₂)_(n)C₆H₄(CH₂)_(m)CONR₂, NR(CH₂)_(n)C₆H₄(CH₂)_(m)CONR₂, O(CH₂)_(n)C₆H₄O(CH₂)_(n)CONR₂, NR(CH₂)_(n)C₆H₄O(CH₂)_(n)CONR₂, PO₃R₂, SO₃R, O(CH₂CH₂O)_(q)R, NR(CH₂CH₂O)_(q)R, (CH₂)_(m)tetrazole, O(CH₂)_(n)-tetrazole, CONR(CH₂)_(m)CHA(CH₂)_(m)CO₂R, NR(CH₂)_(m)CO₂R, NR(CH₂)_(m)CONR₂, CONR(CH₂)_(m)CHA(CH₂)_(m)CONR₂, CONR(CH₂)_(m)CHA(CH₂)_(m)CONR(CH₂)_(m)CHA(CH₂)_(m)CONR₂, CONR(CH₂)_(m)CHA(CH₂)_(m)CONR(CH₂)_(m)CHA(CH₂)_(m)CONR(CH₂)_(m)CHA(CH₂)_(m)CONR₂, CONR(CH₂)_(m)CHA(CH₂)_(m)CONR(CH₂)_(m)CHA(CH₂)_(m)CO₂R, and CONR(CH₂)_(m)CHA(CH₂)_(m)CONR(CH₂)_(m)CHA(CH₂)_(m)CONR(CH₂)_(m)CHA(CH₂)_(m)CO₂R;

X′ at each occurrence is independently selected from halogen, C₁₋₄-alkyl, CF₃, CN, O—C₁₋₆ alkyl, NO₂, O(CH₂CH₂O)_(q)R, and NR(CH₂CH₂O)_(q)R;

Y at each occurrence is independently selected from H, halogen, C₁₋₆ alkyl, CF₃, CN, (CH₂)_(m)C(NH)NR₂, NHCOR, NHSO₂R, (CH₂)_(m)CO₂R, (CH₂)_(m)CONR₂, NRCONR₂, O(CH₂)_(n)CO₂R, O(CH₂)_(n)CONR₂, NRC(O)(CH₂)_(n)CO₂R, NRC(O)(CH₂)_(n)CONR₂, O(CH₂)_(n)C(NH)NR₂, O(CH₂)_(n)C₆H₄(CH₂)_(m)CO₂R, NR(CH₂)_(n)C₆H₄(CH₂)_(m)CO₂R, O(CH₂)_(n)C₆H₄O(CH₂)_(n)CO₂R, NR(CH₂)_(n)C₆H₄O(CH₂)_(n)CO₂R, O(CH₂)_(n)C₆H₄(CH₂)_(m)CONR₂, NR(CH₂)_(n)C₆H₄(CH₂)_(m)CONR₂, O(CH₂)_(n)C₆H₄O(CH₂)_(n)CONR₂, NR(CH₂)_(n)C₆H₄O(CH₂)_(n)CONR₂, PO₃R₂, SO₃R, O(CH₂CH₂O)_(q)R, NR(CH₂CH₂O)_(q)R, (CH₂)_(m)NH(C═NHCN)NHR′, (CH₂)_(m)NH(C═CHNO₂)NHR′, (CH₂)_(m)tetrazole, O(CH₂)_(n)tetrazole, CONR(CH₂)_(m)CHA(CH₂)_(m)CO₂R, NR(CH₂)_(m)CO₂R, NR(CH₂)_(m)CONR₂, CONR(CH₂)_(m)CHA(CH₂)_(m)CONR₂, CONR(CH₂)_(m)CHA(CH₂)_(m)CONR(CH₂)_(m)CHA(CH₂)_(m)CONR₂, CONR(CH₂)_(m)CHA(CH₂)_(m)CONR(CH₂)_(m)CHA(CH₂)_(m)CONR(CH₂)_(m)CHA(CH₂)_(m)CONR₂, CONR(CH₂)_(m)CHA(CH₂)_(m)CONR(CH₂)_(m)CHA(CH₂)_(m)CO₂R, and CONR(CH₂)_(m)CHA(CH₂)_(m)CONR(CH₂)_(m)CHA(CH₂)_(m)CONR(CH₂)_(m)CHA(CH₂)_(m)CO₂R;

Z, Z′, and Z″ are independently N or CY;

A is selected from H, OH, C₁₋₆ alkyl, (CH₂)_(m)C₃₋₆-cycloalkyl, CH₂OH, CH(CH₃)OH, C(CH₃)₂OH, (CH₂)_(n)CONHR and (CH₂)_(m)-phenyl, wherein the phenyl is substituted with 0-3 groups selected from H, C₁₋₄ alkyl, halogen, CF₃, O—C₁₋₄ alkyl, NO₂, NH₂, NHCONHR, NHSO₂CH₃, CONHR, and NHCO₂R′;

Q is selected from H, C₁₋₆ alkyl, (CH₂)_(m)CN, (CH₂)_(m)C(NR)NH₂, (CH₂)_(m)-tetrazole, (CH₂)_(m)C(NR)NH₂, and (CH₂)_(m)O(CH₂CH₂O)_(q)R;

R at each occurrence is independently selected from H and C₁₋₆ alkyl;

R′ at each occurrence is independently C₁₋₆ alkyl;

m at each occurrence is independently selected from 0, 1, 2, 3, and 4;

n at each occurrence is independently selected from 1, 2, 3, and 4; and,

q at each occurrence is independently selected from 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, and 12;

provided that:

(a) Q is other than H and alkyl;

(b) X is other than H, halogen, C₁₋₆ alkyl, CF₃, CN, O—C₁₋₆ alkyl, (CH₂)_(m)tetrazole, O(CH₂)_(n)tetrazole, NRCO₂R, and NRCONR₂; and/or

(c) Y is other than H, halogen, C₁₋₆ alkyl, CF₃, and CN.

[2] In another embodiment, the present invention provides novel compound of Formula I or a stereoisomer or pharmaceutically acceptable salt thereof, wherein:

R₁ and R₂ are independently phenyl or 6-membered heteroaryl, wherein each phenyl or heteroaryl is substituted with 0-2 substituents independently selected from X and X′;

X at each occurrence is independently selected from halogen, C₁₋₆ alkyl, CF₃, CN, OC₁₋₆-alkyl, (CH₂)_(m)C(NH)NR₂, O(CH₂)_(n)CO₂R, O(CH₂)_(n)CONR₂, O(CH₂)_(n)C(NH)NR₂, NR(CH₂)_(n)CO₂R, O(CH₂)_(n)C₆H₄(CH₂)_(m)CO₂R, NR(CH₂)_(n)C₆H₄(CH₂)_(m)CO₂R, O(CH₂)_(n)C₆H₄O(CH₂)_(n)CO₂R, NR(CH₂)_(n)C₆H₄O(CH₂)_(n)CO₂R, O(CH₂)_(n)C₆H₄(CH₂)_(m)CONR₂, NR(CH₂)_(n)C₆H₄(CH₂)_(m)CONR₂, O(CH₂)_(n)C₆H₄O(CH₂)_(n)CONR₂, NR(CH₂)_(n)C₆H₄O(CH₂)_(n)CONR₂, PO₃R₂, SO₃R, O(CH₂CH₂O)_(q)R, NR(CH₂CH₂O)_(q)R, (CH₂)_(m)tetrazole, O(CH₂)_(n)-tetrazole, CONR(CH₂)_(m)CHA(CH₂)_(m)CO₂R, NR(CH₂)_(m)CO₂R, NH(CH₂)_(m)CONH₂, CONH(CH₂)_(m)CHA(CH₂)_(m)CONR₂, CONH(CH₂)_(m)CHA(CH₂)_(m)CONH(CH₂)_(m)CHA(CH₂)_(m)CONR₂, CONH(CH₂)_(m)CHA(CH₂)_(m)CONH(CH₂)_(m)CHA(CH₂)_(m)CONH(CH₂)_(m)CHA(CH₂)_(m)CONR₂, CONH(CH₂)_(m)CHA(CH₂)_(m)CONH(CH₂)_(m)CHA(CH₂)_(m)CO₂R, and CONR(CH₂)_(m)CHA(CH₂)_(m)CONH(CH₂)_(m)CHA(CH₂)_(m)CONH(CH₂)_(m)CHA(CH₂)_(m)CO₂R;

X′ at each occurrence is independently selected from halogen, C₁₋₆ alkyl, CF₃, CN, O—C₁₋₆ alkyl, and NO₂;

Y at each occurrence is independently selected from H, halogen, C₁₋₆ alkyl, CF₃, CN, O(CH₂CH₂O)_(q)R, and NR(CH₂CH₂O)_(q)R;

Z, Z′, and Z″ are independently N or CY;

A is selected from H, OH, C₁₋₄ alkyl, (CH₂)_(m)C₃₋₆-cycloalkyl, CH₂OH, CH(CH₃)OH, C(CH₃)₂OH(CH₂)_(n)CONHR and (CH₂)_(m)-phenyl, wherein the phenyl is substituted with 0-3 groups selected from H, C₁₋₄ alkyl, Cl, F, CF₃, O—C₁₋₁₄ alkyl, NO₂, NH₂, NHCONHR, NHSO₂CH₃, CONHR, and NHCO₂R′;

Q is selected from H, C₁₋₆ alkyl, (CH₂)_(m)CN, and (CH₂)_(m)O(CH₂CH₂O)_(q)R;

R at each occurrence is independently selected from H and C₁₋₆ alkyl;

R′ at each occurrence is independently selected from C₁₋₄ alkyl;

m at each occurrence is independently selected from 0, 1, 2, and 3; and,

n at each occurrence is independently selected from 1, 2, and 3;

provided that:

(a) Q is other than H and alkyl;

(b) X is other than H, halogen, C₁₋₆ alkyl, CF₃, CN, O—C₁₋₆ alkyl, (CH₂)_(m)tetrazole, O(CH₂)_(n)tetrazole, NRCO₂R, and NRCONR₂; and/or

(c) Y is other than H, halogen, C₁₋₆ alkyl, CF₃, and CN.

[3] In another embodiment, the present invention provides novel compounds of formula I or a stereoisomer or pharmaceutically acceptable salt thereof, wherein:

R₁ and R₂ are independently phenyl or 6-membered heteroaryl, wherein each phenyl or heteroaryl is substituted with 0-2 substituents independently selected from X and X′;

X at each occurrence is independently selected from C₁₋₄ alkyl, halogen, CF₃, O—C₁₋₆ alkyl, CN, NO₂, O(CH₂CH₂O)_(q)R, and NR(CH₂CH₂O)_(q)R;

X′ at each occurrence is independently selected from halogen, C₁₋₄ alkyl, CF₃, CN, O—C₁₋₆ alkyl, and NO₂;

Y at each occurrence is independently selected from H, halogen, C₁₋₆ alkyl, CF₃, CN, (CH₂)_(m)C(NH)NR₂, NHCOR, NHSO₂R, (CH₂)_(m)CO₂R, (CH₂)_(m)CONR₂, NHRCONR, O(CH₂)_(n)CO₂R, O(CH₂)_(n)CONR₂, O(CH₂)_(n)C(NH)NR₂, NRC(O)(CH₂)_(n)CO₂R, NRC(O)(CH₂)_(n)CONR₂, O(CH₂)_(n)C₆H₄(CH₂)_(m)CO₂R, NR(CH₂)_(n)C₆H₄(CH₂)_(m)CO₂R, O(CH₂)_(n)C₆H₄O(CH₂)_(n)CO₂R, NR(CH₂)_(n)C₆H₄O(CH₂)_(n)CO₂R, O(CH₂)_(n)C₆H₄(CH₂)_(m)CONR₂, NR(CH₂)_(n)C₆H₄(CH₂)_(m)CONR₂, O(CH₂)_(n)C₆H₄O(CH₂)_(n)CONR₂, NR(CH₂)_(n)C₆H₄O(CH₂)_(n)CONR₂, PO₃R₂, SO₃R, O(CH₂CH₂O)_(q)R, NR(CH₂CH₂O)_(q)R, (CH₂)_(m)—NH(C═NHCN)NHR′, (CH₂)_(m)NH(C═CHNO₂)NHR′, (CH₂)_(m)tetrazole, O(CH₂)_(n)tetrazole, CONH(CH₂)_(m)CHA(CH₂)_(m)CO₂R, NR(CH₂)_(m)CO₂R, NR(CH₂)_(m)CONH₂, CONH(CH₂)_(m)CHA(CH₂)_(m)CONR₂, CONH(CH₂)_(m)CHA(CH₂)_(m)CONH(CH₂)_(m)CHA(CH₂)_(m)CONR₂, CONH(CH₂)_(m)CHA(CH₂)_(m)CONH(CH₂)_(m)CHA(CH₂)_(m)CONH(CH₂)_(m)CHA(CH₂)_(m)CONR₂, CONH(CH₂)_(m)CHA(CH₂)_(m)CONH(CH₂)_(m)CHA(CH₂)_(m)CO₂R, and CONH(CH₂)_(m)CHA(CH₂)_(m)CONH(CH₂)_(m)CHA(CH₂)_(m)CONH(CH₂)_(m)CHA(CH₂)_(m)CO₂R;

Z, Z′, and Z″ are independently N or CY;

A is selected from H, OH, C₁₋₄ alkyl, (CH₂)_(m)C₃₋₆-cycloalkyl, CH₂OH, CH(CH₃)OH, C(CH₃)₂OH(CH₂)_(n)CONR₂ and (CH₂)_(m)-phenyl, wherein the phenyl is substituted with 0-3 groups selected from H, C₁₋₄ alkyl, Cl, F, CF₃, O—C₁₋₁₄ alkyl, NO₂, NH₂, NHCONHR, NHSO₂CH₃, CONHR, and NHCO₂R′;

Q is selected from H and C₁₋₄ alkyl;

R at each occurrence is independently selected from H and C₁₋₄ alkyl;

R′ at each occurrence is independently selected from C₁₋₄ alkyl;

m at each occurrence is independently selected from 0, 1, 2, and 3; and,

n at each occurrence is independently selected from 1, 2, and 3;

provided that:

(d) Q is other than H and alkyl;

(e) X is other than H, halogen, C₁₋₆ alkyl, CF₃, CN, O—C₁₋₆ alkyl, (CH₂)_(m)tetrazole, O(CH₂)_(n)tetrazole, NRCO₂R, and NRCONR₂; and/or

(f) Y is other than H, halogen, C₁₋₆ alkyl, CF₃, and CN.

[4] In another embodiment, the present invention provides novel compounds of formula I or a stereoisomer or pharmaceutically acceptable salt thereof, wherein:

R₁ and R₂ are independently phenyl or 6-membered heteroaryl, wherein each phenyl or heteroaryl is substituted with 0-2 substituents independently selected from X and X′;

X at each occurrence is independently selected from halogen, C₁₋₄-alkyl, CF₃, CN, O—C₁₋₆ alkyl, NO₂, O(CH₂CH₂O)_(q)R, and NR(CH₂CH₂O)_(q)R;

X′ at each occurrence is independently selected from halogen, C₁₋₄-alkyl, CF₃, CN, O—C₁₋₆ alkyl, NO₂, O(CH₂CH₂O)_(q)R, and NR(CH₂CH₂O)_(q)R;

Y is selected from H, halogen, C₁₋₄ alkyl, CF₃, and CN;

Z, Z′, and Z″ are independently N or CH;

Q is selected from (CH₂)_(m)C(NH)NH₂, (CH₂)_(m)-tetrazole, and (CH₂)_(m)O(CH₂CH₂O)_(q)R;

R at each occurrence is independently selected from H and C₁₋₄ alkyl;

m at each occurrence is independently selected from 0, 1, 2, and 3; and,

n at each occurrence is independently selected from 1, 2, and 3.

[5] In another embodiment, the present invention provides novel compounds of formula I or a stereoisomer or pharmaceutically acceptable salt thereof, wherein the compounds are selected from a compound of formula Ia-Id.

[6] In another embodiment, the present invention provides novel compounds of formula Ic or a stereoisomer or pharmaceutically acceptable salt thereof, wherein the compounds are selected from a compound of formula II.

[7] In another embodiment, the present invention provides novel compounds of formula II or a stereoisomer or pharmaceutically acceptable salt thereof, wherein the compounds are selected from a compound of formula IIa.

[8] In another embodiment, the present invention provides novel compounds of formula Ib or a stereoisomer or pharmaceutically acceptable salt thereof, wherein the compounds are selected from a compound of formula III.

[9] In another embodiment, the present invention provides novel compounds of formula III or a stereoisomer or pharmaceutically acceptable salt thereof, wherein the compounds are selected from a compound of formula IIIa.

In another embodiment, the present invention provides novel pharmaceutical compositions, comprising: a pharmaceutically acceptable carrier and a therapeutically effective amount of a compound of the present invention or a pharmaceutically acceptable salt form thereof.

In another embodiment, the present invention provides a novel method for treating a disease, comprising: administering to a patient in need thereof a therapeutically effective amount of a compound of the present invention or a pharmaceutically acceptable salt form thereof, wherein the disease is selected from obesity, diabetes, cardiometabolic disorders, and a combination thereof.

In another embodiment, the diabetes disorder is selected from Type 1 diabetes, Type 2 diabetes, inadequate glucose tolerance, and insulin resistance.

In another embodiment, the cardiometabolic disorder is selected from dyslipidemias (e.g., elevated levels of triglycerides, elevated levels of low-density lipoprotein, or low levels of high-density lipoprotein), and hypertension.

In another embodiment, the present invention provides a novel method for treating a co-morbidity of obesity, comprising: administering to a patient in need thereof a therapeutically effective amount of a compound of the present invention or a pharmaceutically acceptable salt form thereof.

In another embodiment, the co-morbidity is selected from diabetes, Metabolic Syndrome, dementia, and heart disease.

In another embodiment, the co-morbidity is selected from hypertension; gallbladder disease; gastrointestinal disorders; menstrual irregularities; degenerative arthritis; venous statis ulcers; pulmonary hypoventilation syndrome; sleep apnea; snoring; coronary artery disease; arterial sclerotic disease; pseudotumor cerebri; accident proneness; increased risks with surgeries; osteoarthritis; high cholesterol; and, increased incidence of malignancies of the ovaries, cervix, uterus, breasts, prostrate, and gallbladder.

In another embodiment, the present invention also provides a method of preventing or reversing the deposition of adipose tissue in a mammal by the administration of a compound of the present invention. By preventing or reversing the deposition of adipose tissue, compound of the present invention are expected to reduce the incidence or severity of obesity, thereby reducing the incidence or severity of associated co-morbidities.

In another embodiment, the present invention provides a compound of the present invention for use in therapy.

In another embodiment, the present invention provides the use of the present invention for the manufacture of a medicament for the treatment of obesity, diabetes, cardiometabolic disorders, and a combination thereof.

The present invention may be embodied in other specific forms without departing from the spirit or essential attributes thereof. This invention encompasses all combinations of embodiments of the invention noted herein. It is understood that any and all embodiments of the present invention may be taken in conjunction with any other embodiment or embodiments to describe additional embodiments. It is also to be understood that each individual element of the embodiments is intended to be taken individually as its own independent embodiment. Furthermore, any element of an embodiment is meant to be combined with any and all other elements from any embodiment to describe an additional embodiment.

The examples provided in the definitions present in this application are non-inclusive unless otherwise stated. They include but are not limited to the recited examples.

The compounds herein described may have asymmetric centers, geometric centers (e.g., double bond), or both. All chiral, diastereomeric, racemic forms and all geometric isomeric forms of a structure are intended, unless the specific stereochemistry or isomeric form is specifically indicated. Compounds of the present invention containing an asymmetrically substituted atom may be isolated in optically active or racemic forms. It is well known in the art how to prepare optically active forms, such as by resolution of racemic forms, by synthesis from optically active starting materials, or through use of chiral auxiliaries. Geometric isomers of olefins, C═N double bonds, or other types of double bonds may be present in the compounds described herein, and all such stable isomers are included in the present invention. Specifically, cis and trans geometric isomers of the compounds of the present invention may also exist and may be isolated as a mixture of isomers or as separated isomeric forms. All processes used to prepare compounds of the present invention and intermediates made therein are considered to be part of the present invention. All tautomers of shown or described compounds are also considered to be part of the present invention.

“Alkyl” includes both branched and straight-chain saturated aliphatic hydrocarbon groups having the specified number of carbon atoms. C₁₋₆ alkyl, for example, includes C₁, C₂, C₃, C₄, C₅, and C₆ alkyl groups. Examples of alkyl include methyl, ethyl, n-propyl, i-propyl, n-butyl, s-butyl, t-butyl, n-pentyl, and s-pentyl.

“Alkenyl” includes the specified number of hydrocarbon atoms in either straight or branched configuration with one or more unsaturated carbon-carbon bonds that may occur in any stable point along the chain, such as ethenyl and propenyl. C₂₋₆ alkenyl includes C₂, C₃, C₄, C₅, and C₆ alkenyl groups.

“Alkynyl” includes the specified number of hydrocarbon atoms in either straight or branched configuration with one or more triple carbon-carbon bonds that may occur in any stable point along the chain, such as ethynyl and propynyl. C₂₋₆ Alkynyl includes C₂, C₃, C₄, C₅, and C₆ alkynyl groups.

“Cycloalkyl” includes the specified number of hydrocarbon atoms in a saturated ring, such as cyclopropyl, cyclobutyl, cyclopentyl, cyclohexyl, cycloheptyl, and cyclooctyl. C₃₋₈ cycloalkyl includes C₃, C₄, C₅, C₆, C₇, and C₈ cycloalkyl groups.

“Cyclic amine” is a hydrocarbon ring wherein one carbon atom of the ring has been replaced by a nitrogen atom. The cyclic amine can be unsaturated, partially saturated, or fully saturated. The cyclic amine can also be bicyclic, tricyclic, and polycyclic. Examples of cyclic amine include pyrrolidine and piperidine.

Halo” or “halogen” refers to fluoro, chloro, bromo, and iodo.

“Counterion” is used to represent a small, negatively charged species, such as chloride, bromide, hydroxide, acetate, and sulfate.

The group “C₆H₄” represents a phenylene.

“Aryl” refers to any stable 6, 7, 8, 9, 10, 11, 12, or 13 membered monocyclic, bicyclic, or tricyclic ring, wherein at least one ring, if more than one is present, is aromatic. Examples of aryl include fluorenyl, phenyl, naphthyl, indanyl, adamantyl, and tetrahydronaphthyl.

“Heteroaryl” refers to any stable 5, 6, 7, 8, 9, 10, 11, or 12 membered monocyclic, bicyclic, or tricyclic heterocyclic ring that is aromatic, and which consists of carbon atoms and 1, 2, 3, or 4 heteroatoms independently selected from the group consisting of N, O, and S. If the heteroaryl group is bicyclic or tricyclic, then at least one of the two or three rings must contain a heteroatom, though both or all three may each contain one or more heteroatoms. If the heteroaryl group is bicyclic or tricyclic, then only one of the rings must be aromatic. The N group may be N, NH, or N-substituent, depending on the chosen ring and if substituents are recited. The nitrogen and sulfur heteroatoms may optionally be oxidized (e.g., S, S(O), S(O)₂, and N—O). The heteroaryl ring may be attached to its pendant group at any heteroatom or carbon atom that results in a stable structure. The heteroaryl rings described herein may be substituted on carbon or on a nitrogen atom if the resulting compound is stable.

Examples of heteroaryl includes acridinyl, azocinyl, benzimidazolyl, benzofuranyl, benzothiofuranyl, benzothiophenyl, benzoxazolyl, benzoxazolinyl, benzthiazolyl, benztriazolyl, benztetrazolyl, benzisoxazolyl, benzisothiazolyl, benzimidazolinyl, carbazolyl, 4aH-carbazolyl, carbolinyl, chromanyl, chromenyl, cinnolinyl, decahydroquinolinyl, 2H,6H-1,5,2-dithiazinyl, dihydrofuro[2,3-b]tetrahydrofuran, furanyl, furazanyl, imidazolyl, 1H-indazolyl, indolenyl, indolinyl, indolizinyl, indolyl, 3H-indolyl, isatinoyl, isobenzofuranyl, isochromanyl, isoindazolyl, isoindolinyl, isoindolyl, isoquinolinyl, isothiazolyl, isoxazolyl, naphthyridinyl, oxadiazolyl, 1,2,3-oxadiazolyl, 1,2,4-oxadiazolyl, 1,2,5-oxadiazolyl, 1,3,4-oxadiazolyl, oxazolidinyl, oxazolyl, oxindolyl, pyrimidinyl, phenanthridinyl, phenanthrolinyl, phenazinyl, phenothiazinyl, phenoxathinyl, phenoxazinyl, phthalazinyl, pteridinyl, pyranyl, pyrazinyl, pyrazolyl, pyridazinyl, pyridooxazole, pyridoimidazole, pyridothiazole, pyridinyl, pyridyl, pyrimidinyl, 2H-pyrrolyl, pyrrolyl, quinazolinyl, quinolinyl, 4H-quinolizinyl, quinoxalinyl, quinuclidinyl, tetrazolyl, 6H-1,2,5-thiadiazinyl, 1,2,3-thiadiazolyl, 1,2,4-thiadiazolyl, 1,2,5-thiadiazolyl, 1,3,4-thiadiazolyl, thianthrenyl, thiazolyl, thienyl, thienothiazolyl, thienooxazolyl, thienoimidazolyl, thiophenyl, triazinyl, 1,2,3-triazolyl, 1,2,4-triazolyl, 1,2,5-triazolyl, 1,3,4-triazolyl, and xanthenyl.

“Mammal” and “patient” cover warm blooded mammals that are typically under medical care (e.g., humans and domesticated animals). Examples include feline, canine, equine, bovine, and human, as well as just human.

“Treating” or “treatment” covers the treatment of a disease-state in a mammal, and includes: (a) preventing the disease-state from occurring in a mammal, in particular, when such mammal is predisposed to the disease-state but has not yet been diagnosed as having it; (b) inhibiting the disease-state, i.e., arresting it development; and/or (c) relieving the disease-state, i.e., causing regression of the disease state until a desired endpoint is reached.

“Pharmaceutically acceptable salts” refer to derivatives of the disclosed compounds wherein the parent compound is modified by making acid or base salts thereof. Examples of pharmaceutically acceptable salts include, but are not limited to, mineral or organic acid salts of basic residues such as amines; alkali or organic salts of acidic residues such as carboxylic acids; and the like. The pharmaceutically acceptable salts include the conventional non-toxic salts or the quaternary ammonium salts of the parent compound formed, for example, from non-toxic inorganic or organic acids. For example, such conventional non-toxic salts include, but are not limited to, those derived from inorganic and organic acids selected from 1,2-ethanedisulfonic, 2-acetoxybenzoic, 2-hydroxyethanesulfonic, acetic, ascorbic, benzenesulfonic, benzoic, bicarbonic, carbonic, citric, edetic, ethane disulfonic, ethane sulfonic, fumaric, glucoheptonic, gluconic, glutamic, glycolic, glycollyarsanilic, hexylresorcinic, hydrabamic, hydrobromic, hydrochloric, hydroiodide, hydroxymaleic, hydroxynaphthoic, isethionic, lactic, lactobionic, lauryl sulfonic, maleic, malic, mandelic, methanesulfonic, napsylic, nitric, oxalic, pamoic, pantothenic, phenylacetic, phosphoric, polygalacturonic, propionic, salicyclic, stearic, subacetic, succinic, sulfamic, sulfanilic, sulfuric, tannic, tartaric, and toluenesulfonic.

The pharmaceutically acceptable salts of the present invention can be synthesized from the parent compound that contains a basic or acidic moiety by conventional chemical methods. Generally, such salts can be prepared by reacting the free acid or base forms of these compounds with a stoichiometric amount of the appropriate base or acid in water or in an organic solvent, or in a mixture of the two; generally, non-aqueous media like ether, ethyl acetate, ethanol, isopropanol, or acetonitrile are useful. Lists of suitable salts are found in Remington's Pharmaceutical Sciences, 18th ed., Mack Publishing Company, Easton, Pa., 1990, p 1445, the disclosure of which is hereby incorporated by reference.

“Therapeutically effective amount” includes an amount of a compound of the present invention that is effective when administered alone or in combination to treat obesity or another indication listed herein. “Therapeutically effective amount” also includes an amount of the combination of compounds claimed that is effective to treat the desired indication. The combination of compounds can be a synergistic combination. Synergy, as described, for example, by Chou and Talalay, Adv. Enzyme Regul. 1984, 22:27-55, occurs when the effect of the compounds when administered in combination is greater than the additive effect of the compounds when administered alone as a single agent. In general, a synergistic effect is most clearly demonstrated at sub-optimal concentrations of the compounds. Synergy can be in terms of lower cytotoxicity, increased effect, or some other beneficial effect of the combination compared with the individual components.

Obesity is defined as having a body mass index (BMI) of 30 or above. The index is a measure of an individual's body weight relative to height. BMI is calculated by dividing body weight (in kilograms) by height (in meters) squared. Normal and healthy body weight is defined as having a BMI between 20 and 24.9. Overweight is defined as having a BMI≧25. Obesity has reached epidemic proportions in the U.S., with 44 million obese Americans, and an additional eighty million deemed medically overweight.

Obesity is a disease characterized as a condition resulting from the excess accumulation of adipose tissue, especially adipose tissue localized in the abdominal area. It is desirable to treat overweight or obese patients by reducing their amount of adipose tissue, and thereby reducing their overall body weight to within the normal range for their sex and height. In this way, their risk for co-morbidities such as diabetes and cardiovascular disease will be reduced. It is also desirable to prevent normal weight individuals from accumulating additional, excess adipose tissue, effectively maintaining their body weights at a BMI<25, and preventing the development of co-morbidities. It is also desirable to control obesity, effectively preventing overweight and obese individuals from accumulating additional, excess adipose tissue, reducing the risk of further exacerbating their co-morbidities.

Cannabinoid receptors are located in a number of peripheral (non-CNS) tissues, including thyroid gland, adrenal gland, reproductive organs, adipose tissue, liver, muscle, and gastrointestinal tract. Cannabinoid receptor antagonists/inverse agonists being developed to treat obesity and smoking cessation, regardless of route of administration, enter the CNS from the systemic circulation. While present in the systemic circulation, such drugs have access to peripheral tissues. One of skill in the art recognizes that cannabinoid receptor antagonists intended to enter the CNS from the systemic circulation in order to treat obesity and smoking cessation, also have access to cannabinoid receptors in peripheral tissues. Thus, a cannabinoid receptor antagonist useful for the present invention may have some access to the CNS from the systemic circulation.

Drugs enter the CNS from the systemic circulation by crossing the blood-brain barrier (BBB). The BBB is a highly specialized ‘gate-keeper’ that protects the brain by preventing the entry of many potentially harmful substances into the CNS from the systemic circulation. Much is known about the BBB, and of the physical-chemical properties required for compounds transported across it.

Drugs that do not cross the BBB into the CNS or that are readily eliminated through transport mechanisms (J Clin Invest. 97, 2517 (1996)) are known in the literature and have low CNS activity due to their inability to develop brain levels necessary for pharmacological action. The BBB has at least one mechanism to remove drugs prior to their accumulation in the CNS. P-Glycoproteins (P-gp) localized in plasma membrane of the BBB can influence the brain penetration and pharmacological activity of many drugs through translocation across membranes. The lack of accumulation into the brain by some drugs can be explained by their active removal from the brain by P-gp residing in the BBB. For example, the typical opioid drug loperamide, clinically used as an antidiarrheal, is actively removed from the brain by P-gp, thus explaining its lack of opiate-like CNS effects. Another example is domperidone, a dopamine receptor blocker that participates in the P-gp transport (J Clin Invest. 97, 2517 (1996)). Whereas dopamine receptor blockers that cross the BBB can be used to treat schizophrenia, the readily-eliminated domperidone can be used to prevent emesis, without the likelihood of producing adverse CNS effects.

In addition to the above compounds, agents possessing structural characteristics that retard or prevent BBB penetration or contribute to participation in active elimination processes have been identified in various classes of therapeutics. These include antihistamines (Drug Metab. Dispos. 31, 312 (2003)), beta-adrenergic receptor antagonists (B-blockers)(Eur. J. Clin. Pharmacol. 28, Suppl: 21-3 (1985); Br. J. Clin. Pharmacol, 11 (6), 549-553 (1981)), non-nucleoside reverse transcriptase inhibitors (NNRTIs)(J. Pharm Sci., 88(10) 950-954 (1999)), and opioid antagonists. This latter group has been tested in relation to their activity in the GI tract. These peripherally selective opioid antagonists are described in various US patents as being useful in the treatment of non-CNS pathologies in mammals, in particular those of the GI tract (see U.S. Pat. No. 5,260,542; U.S. Pat. No. 5,434,171; U.S. Pat. No. 5,159,081; and U.S. Pat. No. 5,270,238).

Other types of non-brain penetrant compounds can be prepared through the creation of a charge within the molecule. Thus, the addition of a methyl group to the tertiary amine functionality of the drugs scopolamine or atropine, unlike the parent molecules, prevents their passage across the BBB through the presence of a positive charge. However, the new molecules (methyl-scopolamine and methyl-atropine) retain their full anticholinergic pharmacological properties. As such, these drugs can also be used to treat peripheral diseases, without the concern of adverse CNS effects. The quaternary ammonium compound methylnaltrexone is also used for the prevention and/or treatment of opioid and non-opioid induced side effects associated with opioid administration.

The discovery that the anti-obesity activity of cannabinoid receptor antagonists may in part be mediated by a non-CNS mechanism could make it beneficial for the compounds of the present invention to be peripherally restricted, i.e., have an inability or limited ability to cross the BBB, or be readily eliminated from the brain through active transport systems. It may be desirable for the compounds of the present invention to be peripherally restricted, which in turn will result in no or very limited CNS effects. Compounds that provide peripherally mediated anti-obesity properties should result in therapeutic agents with greater safety, as previously demonstrated in earlier classes of peripherally restricted agents. It can be desirable that the compounds of the present invention, when administered in a therapeutically effective amount, have no or very limited CNS effects. It can also be desirable that the lack of CNS effects is a result of the compounds of the present invention having minimal brain concentrations when administered in therapeutically effective amounts. In this context, minimal brain concentrations means levels that are too low to be therapeutically effective for the treatment of a CNS indication or too low to cause significant or measurable deleterious or undesired side effects.

MK-0364 (Compound AA when R₁ is 3-cyanophenyl and R₂ is 4-chlorophenyl, Q is methyl, Z is nitrogen, and Y is CF₃ is a drug that crosses the BBB and is indicated for the treatment of obesity. It is believed that MK-0364 works to treat obesity via a CNS mechanism. Compounds like MK-0364 and others of formula AA have been described in U.S. Pat. No. 6,972,295. In compound AA, one of X, Y, X′, or Q is a group capable of reducing or limiting the CNS activity of compound AA. This reduced or limited CNS activity occurs via at least one of X, Y, X′, or Q being a group that either limits compound AA's ability to cross the BBB relative to that of MK-0364 or enables it to be actively removed from the brain at a rate greater than that of MK-0364. Examples of the amount of compound AA present in the brain can include (a) from 50, 55, 60, 65, 70, 75, 80, 85, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, to 100% lower than MK-0364, (b) from 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, to 100% lower than MK-0364, and (c) from 98, 99, to 100% lower than MK-0364, when administered at the same dosage.

The compounds of the present invention are expected to be cannabinoid receptor antagonists or inverse agonists.

An inverse agonist is compound that not only blocks the action of the endogenous agonist at the receptor, but also exhibits its own activity which is usually the opposite of that shown by the agonist. Inverse agonists are also effective against certain types of receptors (e.g. certain histamine receptors/GABA receptors) which have intrinsic activity without the interaction of a ligand upon them (also referred to as ‘constitutive activity’).

Most methods of treating obesity are dependent on a significant reduction in energy intake, either by a decrease in food intake (e.g., sibutramine) or by inhibition of fat absorption (e.g., orlistat). In the present invention, it can be desirable for adipose tissue to be significantly reduced in the absence of a significant reduction in food intake. The weight loss, as a result of the present invention, comes from the treatment with a CB1 antagonist, largely independent of appetite and food intake. Examples of the level of food intake during adipose tissue loss include (a) food intake is maintained, increased or about 0, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, or 20% below the normal range of the subject prior to being treated in accordance with the present invention (i.e., its pre-administration level); (b) food intake is maintained, increased, or about 0, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, or 15% below its pre-administration level; (c) food intake is maintained, increased or about 0, 1, 2, 3, 4, 5, 6, 7, 8, 9, or 10% below its pre-administration level; and (d) food intake level is maintained, increased or about 0, 1, 2, 3, 4, or 5% below its pre-administration level.

In some cases, loss of adipose tissue can be accompanied by a concomitant loss of lean muscle mass. This is particularly evident in cancer patients who show a wasting of all body tissue components, including adipose tissue and lean muscle mass. In the present invention, however, it can be desirable for body fat to be significantly reduced in the absence of a significant reduction in lean body mass. Adipose tissue loss comes from treatment with a CB1 antagonist, independent of a significant change in lean body mass. Examples of the level of lean body mass during adipose tissue loss include (a) lean body mass is maintained, increased, or is no more than about 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, or 30% below the normal range of the subject prior to being treated in accordance with the present invention (i.e., its pre-administration level); (b) lean body mass is maintained, increased, or is no more than about 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, or 15% below pre-administration levels; (c) lean body mass is maintained, increased, or is no more than about 1, 2, 3, 4, 5, 6, 7, 8, 9, or 10% below pre-administration levels; and (d) lean body mass is maintained, increased, or is no more than about 1, 2, 3, 4, or 5% below pre-administration levels.

In some cases, loss of adipose tissue can be accompanied by a concomitant loss of water mass. This is particularly evident with diet regimens that promote dehydration. In the present invention, it can be desirable for body fat to be significantly reduced in the absence of a significant reduction in water mass. In other words, adipose tissue loss comes from treatment with a CB1 antagonist, independent of a significant change in water mass. Examples of the level of water mass during adipose tissue loss include (a) water mass is maintained, increased, or is no more than about 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, or 30 below the normal range of the subject prior to being treated in accordance with the present invention (i.e., its pre-administration level); (b) water mass is maintained, increased, or is no more than about 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, or 15% below pre-administration levels; (c) water mass is maintained, increased, or is no more than about 1, 2, 3, 4, 5, 6, 7, 8, 9, or 10% below pre-administration levels; and (d) water mass is maintained, increased, or is no more than about 1, 2, 3, 4, or 5% below pre-administration levels.

Sibutramine and orlistat are currently marketed for use in the treatment of obesity. These two compounds achieve weight loss through entirely different mechanisms. Sibutramine, a CNS appetite suppressant, inhibits the neuronal reuptake of serotonin and noradrenaline. Orlistat inhibits gut lipase enzymes that are responsible for breaking down ingested fat.

Cannabinoid receptor antagonists/inverse agonists can promote weight loss through inhibition of peripheral cannabinoid receptors, as well as mechanisms entirely different from appetite suppressants, gut lipase inhibitors, and other agents with similar indications (e.g., serotonin agonists, leptin, fatty acid synthase inhibitors, monoamine oxidase (MAO) inhibitors). Co-administration of a cannabinoid receptor antagonist/inverse agonist together with one or more other agents that are useful for treating the indications described above (e.g., obesity, diabetes, cardiometabolic disorders, and a combination thereof) is expected to be beneficial, by producing, for example, either additive or synergistic effects. Examples of additional agents include an appetite suppressant, a lipase inhibitor, and a MAO inhibitor (e.g., MAO-B, and a combination of MAO-A/B). Therefore, the present invention provides a method of treating obesity, diabetes, and/or cardiometabolic disorders, comprising administering a therapeutically effective amount of a compound of the present invention and a second component effective for treating the desired indication.

Examples of second components include anti-obesity agents, which include, but are not limited to: 1) growth hormone secretagogues; 2) growth hormone secretagogue receptor agonists/antagonists; 3) melanocortin agonists; 4) Mc4r (melanocortin 4 receptor) agonists; 5) .beta.-3 agonists; 7) 5HT2C (serotonin receptor 2C) agonists; 8) orexin antagonists; 9) melanin concentrating hormone antagonists; 10) melanin-concentrating hormone 1 receptor (MCH1R) antagonists; 11) melanin-concentrating hormone 2 receptor (MCH2R) agonist/antagonists; 12) galanin antagonists; 13) CCK agonists; 14) CCK-A (cholecystokinin-A) agonists; 16) corticotropin-releasing hormone agonists; 17) NPY 5 antagonists; 18) NPY 1 antagonists; 19) histamine receptor-3 (H3) modulators; 20) histamine receptor-3 (H3) antagonists/inverse agonists; 21) β-hydroxy steroid dehydrogenase-1 inhibitors (.beta.-HSD-1); 22) PDE (phosphodiesterase) inhibitors; 23) phosphodiesterase-3B (PDE3B) inhibitors; 24) NE (norepinephrine) transport inhibitors; 25) non-selective serotonin/norepinephrine transport inhibitors, such as sibutramine, phentermine, or fenfluramine; 26) ghrelin antagonists; 28) leptin derivatives; 29) BRS3 (bombesin receptor subtype 3) agonists; 30) CNTF (Ciliary neurotrophic factors); 31) CNTF derivatives, such as axokine (Regeneron); 32) monoamine reuptake inhibitors; 33) UCP-1 (uncoupling protein-1), 2, or 3 activators; 34) thyroid hormone .beta. agonists; 35) FAS (fatty acid synthase) inhibitors; 37) DGAT2 (diacylglycerol acyltransferase 2) inhibitors; 38) ACC2 (acetyl-CoA carboxylase-2) inhibitors; 39) glucocorticoid antagonists; 40) acyl-estrogens; 41) lipase inhibitors, such as orlistat (Xenical®); 42) fatty acid transporter inhibitors; 43) dicarboxylate transporter inhibitors; 44) glucose transporter inhibitors; 45) phosphate transporter inhibitors; 46) serotonin reuptake inhibitors; 47) Metformin (Glucophage®); 48) Topiramate (Topimax®); and/or 49) MAO inhibitors.

Examples of MAO inhibitors include Moclobemide; Brofaromine; BW A616U; Ro 41-1049; RS-2232; SR 95191; Harmaline; Harman; Amiflamine; BW 1370U87; FLA 688; FLA 788; Bifemelane; Clorgyline; LY 51641; MDL 72,394; 5-(4-Benzyloxyphenyl)-3-(2-cyanoethyl)-(3H)-1,3,4-oxadiazol-2-one; 5-(4-Arylmethoxyphenyl)-2-(2-cyanoethyl)tetrazoles; Lazabemide; Ro 16-6491; Almoxatone; XB308; RS-1636; RS-1653; NW-1015; SL 340026; L-selegiline; Rasagiline; Pargyline; AGN 1135; MDL 72,974; MDL 72,145; MDL 72,638; LY 54761; MD 780236; MD 240931; Bifemelane; Toloxatone; Cimoxatone; Iproniazid; Phenelzine; Nialamide; Phenylhydrazine; 1-Phenylcyclopropylamine; Isocarboxazid; and, Tranylcypromine. Additional examples of MAO inhibitors can be found in USAN 60/696,067; USAN 60/686,585; USAN 60/698,867; and USAN 60/704,679, the contents of which are incorporated herein by reference.

Examples of second components useful for treating diabetes include (a) insulin sensitizers including (i) PPAR-γ agonists such as the glitazones (e.g. troglitazone, pioglitazone, englitazone, MCC-555, rosiglitazone), and compounds disclosed in WO97/27857, 97/28115, 97/28137, and 97/27847; and (ii) biguanides such as metformin and phenformin; (b) insulin or insulin mimetics; (c) sulfonylureas such as tolbutamide and glipizide, or related materials; (d) α-glucosidase inhibitors (e.g., acarbose); (e) cholesterol lowering agents such as (i) HMG-CoA reductase inhibitors (lovastatin, simvastatin, pravastatin, fluvastatin, atorvastatin, rivastatin, and other statins), (ii) sequestrants (e.g., cholestyramine, colestipol, and dialkylaminoalkyl derivatives of a cross-linked dextran), (iii) nicotinyl alcohol, nicotinic acid or a salt thereof, (iv) PPAR-α agonists (e.g., fenofibric acid derivatives including gemfibrozil, clofibrate, fenofibrate, and bezafibrate), (v) inhibitors of cholesterol absorption (e.g., β-sitosterol) and acyl CoA:cholesterol acyltransferase inhibitors (e.g., melinamide), and (vi) probucol; (f) PPAR-α/γ agonists; (g) antiobesity compounds (described previously); (h) ileal bile acid transporter inhibitors; and (i) insulin receptor activators.

The compounds of the present invention are expected to be CB1 receptor inhibitors/inverse agonists and are expected to be useful for treating diseases mediated by the CB₁ receptor. The compounds of the present are expected to possess an affinity in vitro for the central and/or peripheral cannabinoid receptors under the experimental conditions described by Devane et al., Molecular Pharmacology, 1988, 34, 605-613. The compounds according to the invention are also expected to possess an affinity for the cannabinoid receptors present on preparations of electrically stimulated isolated organs. These tests can be performed on guinea-pig ileum and on mouse vas deferens according to Roselt et al., Acta Physiologica Scandinavia 1975, 94, 142-144, and according to Nicolau et al., Arch. Int. Pharmacodyn, 1978, 236, 131-136.

CB1 receptor affinities can be determined using membrane preparations of Chinese hamster ovary (CHO) cells in which the human cannabinoid CB1 receptor is stably transfected (Biochem J. 1991, 279, 129-134) in conjunction with [3H]CP-55,940 as radioligand. After incubation of a freshly prepared cell membrane preparation with the [3H]-radioligand, with or without addition of test compound, separation of bound and free ligand is performed by filtration over glass fiber filters. Radioactivity on the filter is measured by liquid scintillation counting. The IC₅₀ values can be determined from at least three independent measurements.

In the present invention, the compound(s) of the present invention can be administered in any convenient manner (e.g., enterally or parenterally). Examples of methods of administration include orally and transdermally. One skilled in this art is aware that the routes of administering the compounds of the present invention may vary significantly. In addition to other oral administrations, sustained release compositions may be favored. Other acceptable routes may include injections (e.g., intravenous, intramuscular, subcutaneous, and intraperitoneal); subdermal implants; and, buccal, sublingual, topical, rectal, vaginal, and intranasal administrations. Bioerodible, non-bioerodible, biodegradable, and non-biodegradable systems of administration may also be used. Examples of oral formulations include tablets, coated tablets, hard and soft gelatin capsules, solutions, emulsions, and suspensions.

If a solid composition in the form of tablets is prepared, the main active ingredient can be mixed with a pharmaceutical vehicle, examples of which include silica, starch, lactose, magnesium stearate, and talc. The tablets can be coated with sucrose or another appropriate substance or they can be treated so as to have a sustained or delayed activity and so as to release a predetermined amount of active ingredient continuously. Gelatin capsules can be obtained by mixing the active ingredient with a diluent and incorporating the resulting mixture into soft or hard gelatin capsules. A syrup or elixir can contain the active ingredient in conjunction with a sweetener, which is preferably calorie-free, an antiseptic (e.g., methylparaben and/or propylparaben), a flavoring, and an appropriate color. Water-dispersible powders or granules can contain the active ingredient mixed with dispersants or wetting agents or with suspending agents such as polyvinylpyrrolidone, as well as with sweeteners or taste correctors. Rectal administration can be effected using suppositories, which are prepared with binders melting at the rectal temperature (e.g., cocoa butter and/or polyethylene glycols). Parenteral administration can be effected using aqueous suspensions, isotonic saline solutions, or injectable sterile solutions, which contain pharmacologically compatible dispersants and/or wetting agents (e.g., propylene glycol and/or polyethylene glycol). The active ingredient can also be formulated as microcapsules or microspheres, optionally with one or more carriers or additives. The active ingredient can also be presented in the form of a complex with a cyclodextrin, for example α-, β-, or γ-cyclodextrin, 2-hydroxypropyl-β-cyclodextrin, and/or methyl-β-cyclodextrin.

The dose of the compound of the present invention administered daily will vary on an individual basis and to some extent may be determined by the severity of the disease being treated (e.g., obesity, diabetes, and cardiometabolic disorders). The dose of the compound of the present invention will also vary depending on the compound administered. Examples of dosages of compounds of the present invention include from about 0.01, 0.02, 0.03, 0.04, 0.05, 0.06, 0.07, 0.08, 0.09, 0.1, 0.2, 0.3, 0.4, 0.5, 0.6, 0.7, 0.8, 0.9, 1.0, 2, 3, 4, 5, 6, 7, 8, 9, 10, 15, 20, 25, 30, 35, 40, 45, 50, 55, 60, 65, 70, 76, 80, 85, 90, 95, to 100 mg/kg of mammal body weight. The compound can be administered in a single dose or in a number of smaller doses over a period of time. The length of time during which the compound is administered varies on an individual basis, and can continue until the desired results are achieved (i.e., reduction of body fat, prevention of a gain in body fat, reduced glucose levels, improved insulin sensitivity). Therapy could, therefore, last from 1 day to weeks, months, or even years depending upon the subject being treated, the desired results, and how quickly the subject responds to treatment in accordance with the present invention.

A possible example of a tablet of the present invention is as follows.

Ingredient mg/Tablet Active ingredient 100 Powdered lactose 95 White corn starch 35 Polyvinylpyrrolidone 8 Na carboxymethylstarch 10 Magnesium stearate 2 Tablet weight 250

A possible example of a capsule of the present invention is as follows.

Ingredient mg/Tablet Active ingredient 50 Crystalline lactose 60 Microcrystalline cellulose 34 Talc 5 Magnesium stearate 1 Capsule fill weight 150

In the above capsule, the active ingredient has a suitable particle size. The crystalline lactose and the microcrystalline cellulose are homogeneously mixed with one another, sieved, and thereafter the talc and magnesium stearate are admixed. The final mixture is filled into hard gelatin capsules of suitable size.

A possible example of an injection solution of the present invention is as follows.

Ingredient mg/Tablet Active substance 1.0 mg 1 N HCl 20.0 μl acetic acid 0.5 mg NaCl 8.0 mg Phenol 10.0 mg 1 N NaOH q.s. ad pH 5 H₂O q.s. ad 1 mL

Synthesis

The compounds of the present invention can be prepared in a number of ways known to one skilled in the art of organic synthesis (e.g., see U.S. Pat. No. 6,972,295, J Med Chem 1967, 10, 719). The compounds of the present invention can be synthesized using the methods described below, together with synthetic methods known in the art of synthetic organic chemistry, or by variations thereon as appreciated by those skilled in the art. Preferred methods include, but are not limited to, those described below. The reactions are performed in a solvent appropriate to the reagents and materials employed and suitable for the transformations being effected. It will be understood by those skilled in the art of organic synthesis that the functionality present on the molecule should be consistent with the transformations proposed. This will sometimes require a judgment to modify the order of the synthetic steps or to select one particular process scheme over another in order to obtain a desired compound of the invention. It will also be recognized that another major consideration in the planning of any synthetic route in this field is the judicious choice of the protecting group used for protection of the reactive functional groups present in the compounds described in this invention. An authoritative account describing the many alternatives to the trained practitioner is Greene and Wuts (Protective Groups In Organic Synthesis, Wiley and Sons, 1991). All references cited herein are hereby incorporated in their entirety herein by reference.

Scheme 1 shows how 3-cyanophenylacetone [J. Med. Chem., 10. 717 (1967)] can be alkylated with ethyl (4-bromomethyl)phenoxyacetate (which can be produced from 4-hydroxybenzyl alcohol via alkylation with ethyl bromoacetate in acetone in the presence of potassium carbonate, and bromination with NBS/Ph₃P) in THF in the presence of sodium hexamethyldisilazide at about −70° C. to ambient temperature over a 6-12 hour period to afford the butanone derivative (step a). Reductive amination of the ketone with sodium cyanoborohydride and ammonium acetate in acetonitrile containing acetic acid at ambient temperature to 40° C. should yield the amine (step b). 2-Aryloxy-2-methyl-propionic acids can be prepared according to the procedures found in U.S. Pat. No. 6,972,295. When 2-methyl-2-(5-trifluoromethyl-2-pyridinoxy) propionic acid in methylene chloride is treated with oxalyl chloride and a drop or two of DMF, the acid chloride should result. Reaction of the resultant acid chloride with the amino ester in the presence of diisopropylethyl amine in methylene chloride at room temperature should afford the amide adduct (step c). Hydrolysis of the ester using lithium hydroxide in aqueous THF should produce the acid (step d). Alternatively, the ester can be converted to the amide using anhydrous ammonia in alcohol (step e).

Scheme 2 shows how the addition of N-[3-(4-chlorophenyl)-2-(3-cyanophenyl)-methylpropyl]amine (U.S. Pat. No. 6,972,295) in methylene chloride to a solution of 2-methyl-2-(5-trifluoromethyl-2-pyridinoxy) propionic acid chloride, generated from oxalyl chloride and a drop or two of DMF, in methylene chloride in the presence of a base such as N-methylmorpholine should produce the amide (step a). The benzonitrile derivative can be converted to the imidate ester by treatment with HCl gas in MeOH/CHCl₃; further reaction with ammonium carbonate in MeOH can afford the carboxamidine (step b). Alternatively, if the benzonitrile derivative is treated with sodium azide in aqueous solution in the presence of zinc salts [J. Org. Chem., 66, 7945, (2001)], the 1H-tetrazole can be produced (step c). This nitrile can also be reacted with tri-n-butyltin azide, conveniently prepared in situ by the reaction of one equivalent of sodium azide and one equivalent of tri-n-butyltin chloride (see J. Med. Chem. 1991, 56, 2395), in reluxing toluene or xylene to afford the tri-n-butyltin-tetrazole adduct. The tri-n-butyltin-adduct can be converted to the trityl-tetrazole derivative by treatment with one equivalent of aqueous sodium hydroxide solution and one equivalent of trityl chloride at room temperature. Removal of the trityl group with aqueous TFA in THF at room temperature should also yield the unprotected tetrazole.

Scheme 3 shows the alkylation of 3-chlorophenylacetone [J. Med. Chem., 10. 717 (1967); U.S. Pat. No. 6,972,295] with 4-bromomethylbenzylcyanide (U.S. Pat. No. 5,124,326) in methylene chloride in the presence of cesium hydroxide monohydrate and a catalytic amount of tetrabutyl ammonium iodide at −70° C. to ambient temperature over a 6-8 hour period can produce the cyanomethylbenzyl adduct (step a). Reductive amination of the ketone with sodium cyanoborohydride and ammonium acetate in acetonitrile containing acetic acid at ambient temperature to about 40° C. should yield the amine (step b). When this amine is treated with an acid chloride such as that produced as indicated above from 2-methyl-2-(5-trifluoromethyl-2-pyridinoxy) propionic acid in methylene chloride in the presence of a base such as diisopropylethyl amine in methylene chloride at room temperature, the amide should result (step c). The nitrile can be converted to the imidate ester by treatment with HCl gas in MeOH/CHCl₃; further reaction with ammonium carbonate in MeOH can afford the carboxamidine (step d).

Scheme 4 illustrates how phenylacetone [J. Med. Chem., 10. 717 (1967); U.S. Pat. No. 6,972,295] can be alkylated with 4-cyanomethyleneoxybenzylbromide (which can be produced from 4-hydroxybenzyl alcohol via alkylation with bromoacetonitrile and subsequent bromination with NBS/Ph₃P) in methylene chloride in the presence of cesium hydroxide monohydrate and a catalytic amount of tetrabutyl ammonium iodide at −70° C. to ambient temperature over a 6-8 hour period to produce the cyanomethyleneoxybenzyl adduct (step a). Reductive amination of the ketone with sodium cyanoborohydride and ammonium acetate in acetonitrile containing acetic acid at ambient temperature to about 40° C. should yield the amine (step b). When this amine is treated with an acid chloride such as that produced as indicated above from 2-methyl-2-(5-trifluoromethyl-2-pyridinoxy) propionic acid in methylene chloride in the presence of a base such as diisopropylethyl amine in methylene chloride at room temperature, the amide should result (step c). The nitrile can be converted to the imidate ester by treatment with HCl gas in MeOH/CHCl₃; further reaction with ammonium carbonate in MeOH can afford the carboxamidine (step d).

Scheme 5 shows how 3-cyanophenylacetone [J. Med. Chem., 10. 717 (1967)] can be alkylated with a pegylated-hydroxybenzyl bromide {which can be produced from 3-, or 4-hydroxybenzaldehye via alkylation with an alkyl- or a TBDMS-capped polyethylene glycol halide [Nuclear Medicine Biology, 32, 799 (2005)] followed by sodium borohydride reduction and standard conversion of the alcohol to bromide} in methylene chloride in the presence of cesium hydroxide monohydrate and a catalytic amount of tetrabutyl ammonium iodide at −70° C. to ambient temperature over a 6-8 hour period to produce the pegylated adduct (step a). Reductive amination of the ketone with sodium cyanoborohydride and ammonium acetate in acetonitrile containing acetic acid at ambient temperature to about 40° C. should yield the amine (step b). When this amine is treated with an acid chloride such as that produced as indicated above from 2-methyl-2-(5-trifluoromethyl-2-pyridinoxy) propionic acid in methylene chloride in the presence of a base such as diisopropylethyl amine in methylene chloride at room temperature, the amide should result (step c). In the case where a TBDMS group is capping the PEG pendant, treatment with tetrabutylammonium fluoride in THF solution at room temperature should produce the alcohol (step d).

Scheme 6 indicates how 2-amino-3-(3-chlorophenyl)-4-(4-chlorophenyl)butane (U.S. Pat. No. 6,972,295) can be treated with an acid chloride such as that produced from 2-(5-cyano-2-pyridinoxy)-2-methylpropionic acid in methylene chloride in the presence of a base such as diisopropylethyl amine in methylene chloride at room temperature to yield the amide (step a).

2-Methyl-2-(5-cyano-2-pyridinoxy) propionic acid can be prepared by methods described in U.S. Pat. No. 6,972,295. Treatment of 5-cyano-2-hydroxypyridine [Chemical Abstracts, 25, 4268 (1931)] in methylene chloride with trimethylsilylethoxymethyl chloride in acetonitrile in the presence of cesium carbonate can give the corresponding N-trimethylsilylethoxymethylpyridone. Condensation of this material with benzyl 2-trifluoromethylmethanesulfonyloxypropionate, formed from benzyl lactate and trifluoromethanesulfonyl anhydride in methylene chloride in the presence of N-methylmorpholine at about −20° C., should give after heating at about 60° C. for 12-24 hours the benzyl 2-(5-cyano-2-pyridyloxy)propionate. Alkylation of this ester with methyl iodide in the presence of sodium hexamethyldisilazide in THF at −78° C. can produce the benzyl 2-(5-cyano-2-pyridyloxy)-2-methylpropionate. Hydrogenolysis of this material can be accomplished using a Pd on C catalyst in ethanol in a hydrogen atmosphere to afford the requisite carboxylic acid.

The amide of step a can be converted to the imidate ester by treatment with HCl gas in MeOH/CHCl₃; further reaction with ammonium carbonate in MeOH can afford the carboxamidine (step b). If the nitrile derivative is treated with sodium azide in aqueous solution in the presence of zinc salts [J. Org. Chem. 2001, 66, 7945], the 1H-tetrazole should be produced (step c). This nitrile can also be reacted with tri-n-butyltin azide, conveniently prepared in situ by the reaction of one equivalent of sodium azide and one equivalent of tri-n-butyltin chloride (see J. Med. Chem. 1991, 56, 2395), in reluxing toluene or xylene to afford the tri-n-butyltin-tetrazole adduct. The tri-n-butyltin-adduct can be converted to the trityl-tetrazole derivative by treatment with one equivalent of aqueous sodium hydroxide solution and one equivalent of trityl chloride at room temperature. Removal of the trityl group with aqueous TFA in THF at room temperature should also yield the unprotected tetrazole. If the nitrile is exposed to 30% hydrogen peroxide in DMSO in the presence of potassium carbonate at room temperature to 40 degrees C., the carboxamide should form (step d). Treatment of the nitrile to aqueous hydroxide solution in n-butanol at elevated temperature can produce the acid (step e). The acid can be coupled with amino acid esters, such as alanine ethyl ester, under standard peptide coupling conditions to give the alanine adduct (step f). Hydrolysis of the ester group using lithium hydroxide in aqueous THF should result in the acid (step g). Treatment of the ester with anhydrous ammonia in methanol can produce the carboxamide. (step h).

Scheme 7 shows the route whereby 2-amino-3-(3-cyanophenyl)-4-(4-chlorophenyl)butane (U.S. Pat. No. 6,972,295) can be treated with an acid chloride such as that produced from 2-(5-nitro-2-pyridinoxy)-2-methylpropionic acid in methylene chloride in the presence of a base such as diisopropylethyl amine in methylene chloride at room temperature to yield the amide (step a).

2-Methyl-2-(5-nitro-2-pyridinoxy) propionic acid can be prepared by methods described in U.S. Pat. No. 6,972,295. Treatment of 5-nitro-2-hydroxypyridine (U.S. Pat. No. 6,841,549) in methylene chloride with trimethylsilylethoxymethyl chloride in acetonitrile in the presence of cesium carbonate can give the corresponding N-trimethylsilylethoxymethylpyridone. Condensation of this material with benzyl 2-trifluoromethylmethanesulfonyloxypropionate, formed from benzyl lactate and trifluoromethanesulfonyl anhydride in methylene chloride in the presence of N-methyl-morpholine at about −20° C., should give after heating at about 60° C. for 12-24 hours the benzyl 2-(5-nitro-2-pyridyloxy)propionate. Alkylation of this ester with methyl iodide in the presence of sodium hexamethyldisilazide in THF at −78° C. can produce the benzyl 2-(5-nitro-2-pyridyloxy)-2-methylpropionate. Hydrolysis of this material using a lithium hydroxide in aqueous THF can give the requisite carboxylic acid.

Reduction of the nitro group can be accomplished using sodium dithionite in ammonium hydroxide solution in aqueous THF (step b). Treatment of the amine with methanesulfonyl chloride in dichloromethane in the presence of a base can produce the sulfonamide (step c). Reductive amination of the amine with ethyl glyoxalate using sodium triacetoxy borohydride in dichloroethane and acetic acid can produce the amino ester (step d). Hydrolysis of this ester using lithium hydroxide in aqueous THF can afford the acid (step e). Treatment of the amide ester with anhydrous ammonia in methanol can produce the amide (step f). Reaction of the amine with ethyl malonyl chloride in methylene chloride in the presence of a base should yield the amide ester (step g). Hydrolysis of this ester using lithium hydroxide in aqueous THF can afford the acid (step h). Treatment of the amide ester with anhydrous ammonia in methanol can produce the amide (step i).

Scheme 8 indicates how 2-amino-3-(3-chlorophenyl)-4-(4-chlorophenyl)butane (U.S. Pat. No. 6,972,295) can be treated with an acid chloride such as that produced from 2-(5-cyanomethyleneoxy-2-pyridinoxy)-2-methylpropionic acid in methylene chloride in the presence of a base such as diisopropylethyl amine in methylene chloride at room temperature to yield the amide (step a).

2-Methyl-2-(5-cyanomethyleneoxy-2-pyridinoxy)propionic acid can be prepared by methods described in U.S. Pat. No. 4,406,907. Treatment of 5-hydroxy-2-chloropyridine with sodium hydride in DMF at about 0° C. can be followed by addition of benzyl bromide at about 60° C. can produce the benzyl ether. Condensation of this ether with the sodium salt of ethyl glycolate in diglyme at 100-130° C. should afford the 2-pyridyloxyacetic ester derivative. Alkylation of this ester with sodium hexamethydisilazide and methyl iodide in THF at −78° C. to ambient temperature can give the dimethyalted ester upon repetition of this procedure. The benzyl group can then removed via hydrogenolysis using Pd/C in ethanol in a hydrogen atmosphere, and the resultant hydroxylpyridine derivative can be alkylated with bromoacetonitrile in the presence of sodium hydride in DMF to produce the cyanomethyleneoxy compound. Hydrolysis of the ester group using lithium hydroxide in aqueous THF should result in the desired acid.

The product of step a can be converted to the carboxamide by exposure to 30% hydrogen peroxide in DMSO in the presence of potassium carbonate at room temperature to 40° C. (step b). Treatment of the product of step-a with HCl gas in MeOH/CHCl₃ can produce the imidate ester; further reaction with ammonium carbonate in MeOH can afford the carboxamidine (step c). If the nitrile derivative is treated with sodium azide in aqueous solution in the presence of zinc salts [J. Org. Chem. 2001, 66, 7945], the 1H-tetrazole should be produced (step d). Treatment of the nitrile to aqueous hydroxide solution in n-butanol at elevated temperature can produce the acid (step e).

Scheme 9 shows 2-Amino-3-(3-cyanophenyl)-4-(4-chlorophenyl)butane (U.S. Pat. No. 6,972,295) can be treated with an acid chloride such as that produced from 2-(5-(2-tert-butyl-dimethylsilanoxy-(ethoxy)_(n-1)-ethyl)-pyridinoxy)-2-methylpropionic acid in methylene chloride in the presence of a base such as diisopropylethyl amine in methylene chloride at room temperature to yield the amide (step a).

2-Methyl-2-(5-(2-tert-butyl-dimethylsilanoxy-(ethoxy)_(n-1)-ethyl)-2-pyridinoxy)propionic acid can be prepared by methods described in U.S. Pat. No. 4,406,907. Treatment of 5-hydroxy-2-chloropyridine with sodium hydride in DMF at about 0° C. can be followed by condensation with 2-tert-butyl-dimethylsilanoxy-(ethoxy)_(n-1)-ethyl bromide [Nuclear Medicine Biology, 32, 799 (2005)] at about 100° C. can produce the 1 ether. Condensation of this ether with the sodium salt of ethyl glycolate in diglyme at 100-130° C. should afford the 2-pyridyloxyacetic acid derivative. Alkylation of this ester with sodium hexamethydisilazide and methyl iodide in THF at −78° C. to ambient temperature can give the dimethyalted ester upon repetition of this procedure. Hydrolysis of the ester group using lithium hydroxide in aqueous THF should result in the acid.

The tert-butyl-dimethylsilanoxy group can be removed by treatment with tetrabutylammonium fluoride in THF at room temperature to yield the alcohol (step b).

Scheme 10 shows (3-(ethyl carboxymethyleneoxy)phenyl)acetone, prepared via alkylation of 3-hydroxyphenylacetone with ethyl bromoacetate in acetone in the presence of potassium carbonate, can be alkylated (U.S. Pat. No. 6,972,295) with 4-cyanobenzyl chloride in THF in the presence of sodium hexamethyldisilazide at about −70° C. to ambient temperature over a 6-12 hour period to afford the butanone derivative (step a). Reductive amination of the ketone with sodium triacetoxyborohydride and ammonium acetate in dichlooethane containing acetic acid at ambient temperature to about 40° C. should yield the amine (step b). When this amine is treated with an acid chloride such as that produced as indicated above from 2-methyl-2-(5-trifluoromethyl-2-pyridinoxy)propionic acid in methylene chloride in the presence of a base such as diisopropylethyl amine in methylene chloride at room temperature, the amide should result (step c). Hydrolysis of the ester group using lithium hydroxide in aqueous THF should result in the acid (step d). Treatment of the ester with anhydrous ammonia in methanol can produce the carboxamide (step e).

Scheme 11 shows how 3-cyanophenylacetone [J. Med. Chem., 10. 717 (1967)] can be alkylated with ethyl (4-bromomethyl)benzoate in THF in the presence of sodium hexamethyldisilazide at about −70° C. to ambient temperature over a 6-12 hour period to afford the butanone derivative (step a). Reductive amination of the ketone with sodium cyanoborohydride and ammonium acetate in acetonitrile containing acetic acid at ambient temperature to 40° C. should yield the amine (step b). 2-Aryloxy-2-methyl-propionic acids can be prepared according to the procedures found in U.S. Pat. No. 6,972,295. When 2-methyl-2-(5-trifluoromethyl-2-pyridinoxy) propionic acid in methylene chloride is treated with oxalyl chloride and a drop or two of DMF, the acid chloride should result. Reaction of the resultant acid chloride with the amino ester in the presence of diisopropylethyl amine in methylene chloride at room temperature should afford the amide adduct (step c). Hydrolysis of the ester using lithium hydroxide in aqueous THF should produce the acid (step d). Coupling of the acid with amino acid esters, such as alanine methyl ester, under standard peptide coupling conditions should give the alanine adduct (step e). Aminolysis of the ester group using anhydrous ammonia in methanol should result in the carboxamide (step f). Alternatively, hydrolysis of the ester followed by coupling with a second amino acid ester, such as glycine, should afford the di-amino acid ester adduct (step g) that can also be converted to the carboxamide (step h).

One stereoisomer of a compound of the present invention may be a more potent cannabinoid receptor antagonist than its counterpart(s). Thus, stereoisomers are included in the present invention. When required, separation of the racemic material can be achieved by HPLC using a chiral column or by a resolution using a resolving agent such as described in Wilen, S. H. Tables of Resolving Agents and Optical Resolutions 1972, 308 or using enantiomerically pure acids and bases. A chiral compound of the present invention may also be directly synthesized using a chiral catalyst or a chiral ligand, e.g., Jacobsen, E. Acc. Chem. Res. 2000, 33, 421-431 or using other enantio- and diastereo-selective reactions and reagents known to one skilled in the art of asymmetric synthesis. Examples of stereoisomers include compounds of formula Ia, Ib, Ic and Id shown below.

Other features of the invention will become apparent in the course of the following descriptions of exemplary embodiments that are given for illustration of the invention and are not intended to be limiting thereof.

EXAMPLES

Tables 1-6 show representative examples of the compounds of the present invention. Each example in each table represents an individual species of the present invention.

TABLE 1 A

Number X^(b) X^(a) Z^(a) Z^(b) 1 H C(NH)NH₂ CH CH 2 Cl C(NH)NH₂ CH CH 3 F C(NH)NH₂ CH CH 4 CH₃ C(NH)NH₂ CH CH 5 OCH₃ C(NH)NH₂ CH CH 6 Br C(NH)NH₂ CH CH 7 CF₃ C(NH)NH₂ CH CH 8 H OCH₂C(NH)NH₂ CH CH 9 Cl OCH₂C(NH)NH₂ CH CH 10 F OCH₂C(NH)NH₂ CH CH 11 CH₃ OCH₂C(NH)NH₂ CH CH 12 OCH₃ OCH₂C(NH)NH₂ CH CH 13 Br OCH₂C(NH)NH₂ CH CH 14 CF₃ OCH₂C(NH)NH₂ CH CH 15 H CH₂C(NH)NH₂ CH CH 16 Cl CH₂C(NH)NH₂ CH CH 17 F CH₂C(NH)NH₂ CH CH 18 CH₃ CH₂C(NH)NH₂ CH CH 19 OCH₃ CH₂C(NH)NH₂ CH CH 20 Br CH₂C(NH)NH₂ CH CH 21 CF₃ CH₂C(NH)NH₂ CH CH 22 H tetrazole CH CH 23 Cl tetrazole CH CH 24 F tetrazole CH CH 25 CH₃ tetrazole CH CH 26 OCH₃ tetrazole CH CH 27 Br tetrazole CH CH 28 CF₃ tetrazole CH CH 29 H OCH₂-tetrazole CH CH 30 Cl OCH₂-tetrazole CH CH 31 F OCH₂-tetrazole CH CH 32 CH₃ OCH₂-tetrazole CH CH 33 OCH₃ OCH₂-tetrazole CH CH 34 Br OCH₂-tetrazole CH CH 35 CF₃ OCH₂-tetrazole CH CH 36 H O(CH₂CH₂O)₃Et CH CH 37 Cl O(CH₂CH₂O)₃Et CH CH 38 F O(CH₂CH₂O)₃Et CH CH 39 CH₃ O(CH₂CH₂O)₃Et CH CH 40 OCH₃ O(CH₂CH₂O)₃Et CH CH 41 Br O(CH₂CH₂O)₃Et CH CH 42 CF₃ O(CH₂CH₂O)₃Et CH CH 43 H O(CH₂CH₂O)₆Et CH CH 44 Cl O(CH₂CH₂O)₆Et CH CH 45 F O(CH₂CH₂O)₆Et CH CH 46 CH₃ O(CH₂CH₂O)₆Et CH CH 47 OCH₃ O(CH₂CH₂O)₆Et CH CH 48 Br O(CH₂CH₂O)₆Et CH CH 49 CF₃ O(CH₂CH₂O)₆Et CH CH 50 H O(CH₂CH₂O)₃H CH CH 51 Cl O(CH₂CH₂O)₃H CH CH 52 F O(CH₂CH₂O)₃H CH CH 53 CH₃ O(CH₂CH₂O)₃H CH CH 54 OCH₃ O(CH₂CH₂O)₃H CH CH 55 Br O(CH₂CH₂O)₃H CH CH 56 CF₃ O(CH₂CH₂O)₃H CH CH 57 H O(CH₂CH₂O)₆H CH CH 58 Cl O(CH₂CH₂O)₆H CH CH 59 F O(CH₂CH₂O)₆H CH CH 60 CH₃ O(CH₂CH₂O)₆H CH CH 61 OCH₃ O(CH₂CH₂O)₆H CH CH 62 Br O(CH₂CH₂O)₆H CH CH 63 CF₃ O(CH₂CH₂O)₆H CH CH 64 H C(NH)NH₂ N CH 65 Cl C(NH)NH₂ N CH 66 F C(NH)NH₂ N CH 67 CH₃ C(NH)NH₂ N CH 68 OCH₃ C(NH)NH₂ N CH 69 Br C(NH)NH₂ N CH 70 CF₃ C(NH)NH₂ N CH 71 H OCH₂C(NH)NH₂ N CH 72 Cl OCH₂C(NH)NH₂ N CH 73 F OCH₂C(NH)NH₂ N CH 74 CH₃ OCH₂C(NH)NH₂ N CH 75 OCH₃ OCH₂C(NH)NH₂ N CH 76 Br OCH₂C(NH)NH₂ N CH 77 CF₃ OCH₂C(NH)NH₂ N CH 78 H CH₂C(NH)NH₂ N CH 79 Cl CH₂C(NH)NH₂ N CH 80 F CH₂C(NH)NH₂ N CH 81 CH₃ CH₂C(NH)NH₂ N CH 82 OCH₃ CH₂C(NH)NH₂ N CH 83 Br CH₂C(NH)NH₂ N CH 84 CF₃ CH₂C(NH)NH₂ N CH 85 tetrazole N CH 86 Cl tetrazole N CH 87 F tetrazole N CH 88 CH₃ tetrazole N CH 89 OCH₃ tetrazole N CH 90 Br tetrazole N CH 91 CF₃ tetrazole N CH 92 H OCH₂-tetrazole N CH 93 Cl OCH₂-tetrazole N CH 94 F OCH₂-tetrazole N CH 95 CH₃ OCH₂-tetrazole N CH 96 OCH₃ OCH₂-tetrazole N CH 97 Br OCH₂-tetrazole N CH 98 CF₃ OCH₂-tetrazole N CH 99 H O(CH₂CH₂O)₃Et N CH 100 Cl O(CH₂CH₂O)₃Et N CH 101 F O(CH₂CH₂O)₃Et N CH 102 CH₃ O(CH₂CH₂O)₃Et N CH 103 OCH₃ O(CH₂CH₂O)₃Et N CH 104 Br O(CH₂CH₂O)₃Et N CH 105 CF₃ O(CH₂CH₂O)₃Et N CH 106 H O(CH₂CH₂O)₆Et N CH 107 Cl O(CH₂CH₂O)₆Et N CH 108 F O(CH₂CH₂O)₆Et N CH 109 CH₃ O(CH₂CH₂O)₆Et N CH 110 OCH₃ O(CH₂CH₂O)₆Et N CH 111 Br O(CH₂CH₂O)₆Et N CH 112 CF₃ O(CH₂CH₂O)₆Et N CH 113 H O(CH₂CH₂O)₃H N CH 114 Cl O(CH₂CH₂O)₃H N CH 115 F O(CH₂CH₂O)₃H N CH 116 CH₃ O(CH₂CH₂O)₃H N CH 117 OCH₃ O(CH₂CH₂O)₃H N CH 118 Br O(CH₂CH₂O)₃H N CH 119 CF₃ O(CH₂CH₂O)₃H N CH 120 H O(CH₂CH₂O)₆H N CH 121 Cl O(CH₂CH₂O)₆H N CH 122 F O(CH₂CH₂O)₆H N CH 123 CH₃ O(CH₂CH₂O)₆H N CH 124 OCH₃ O(CH₂CH₂O)₆H N CH 125 Br O(CH₂CH₂O)₆H N CH 126 CF₃ O(CH₂CH₂O)₆H N CH 127 H C(NH)NH₂ CH N 128 Cl C(NH)NH₂ CH N 129 F C(NH)NH₂ CH N 130 CH₃ C(NH)NH₂ CH N 131 OCH₃ C(NH)NH₂ CH N 132 Br C(NH)NH₂ CH N 133 CF₃ C(NH)NH₂ CH N 134 H OCH₂C(NH)NH₂ CH N 135 Cl OCH₂C(NH)NH₂ CH N 136 F OCH₂C(NH)NH₂ CH N 137 CH₃ OCH₂C(NH)NH₂ CH N 138 OCH₃ OCH₂C(NH)NH₂ CH N 139 Br OCH₂C(NH)NH₂ CH N 140 CF₃ OCH₂C(NH)NH₂ CH N 141 H CH₂C(NH)NH₂ CH N 142 Cl CH₂C(NH)NH₂ CH N 143 F CH₂C(NH)NH₂ CH N 144 CH₃ CH₂C(NH)NH₂ CH N 145 OCH₃ CH₂C(NH)NH₂ CH N 146 Br CH₂C(NH)NH₂ CH N 147 CF₃ CH₂C(NH)NH₂ CH N 148 H tetrazole CH N 149 Cl tetrazole CH N 150 F tetrazole CH N 151 CH₃ tetrazole CH N 152 OCH₃ tetrazole CH N 153 Br tetrazole CH N 154 CF₃ tetrazole CH N 155 H OCH₂-tetrazole CH N 156 Cl OCH₂-tetrazole CH N 157 F OCH₂-tetrazole CH N 158 CH₃ OCH₂-tetrazole CH N 159 OCH₃ OCH₂-tetrazole CH N 160 Br OCH₂-tetrazole CH N 161 CF₃ OCH₂-tetrazole CH N 162 H O(CH₂CH₂O)₃Et CH N 163 Cl O(CH₂CH₂O)₃Et CH N 164 F O(CH₂CH₂O)₃Et CH N 165 CH₃ O(CH₂CH₂O)₃Et CH N 166 OCH₃ O(CH₂CH₂O)₃Et CH N 167 Br O(CH₂CH₂O)₃Et CH N 168 CF₃ O(CH₂CH₂O)₃Et CH N 169 H O(CH₂CH₂O)₆Et CH N 170 Cl O(CH₂CH₂O)₆Et CH N 171 F O(CH₂CH₂O)₆Et CH N 172 CH₃ O(CH₂CH₂O)₆Et CH N 173 OCH₃ O(CH₂CH₂O)₆Et CH N 174 Br O(CH₂CH₂O)₆Et CH N 175 CF₃ O(CH₂CH₂O)₆Et CH N 176 H O(CH₂CH₂O)₃H CH N 177 Cl O(CH₂CH₂O)₃H CH N 178 F O(CH₂CH₂O)₃H CH N 179 CH₃ O(CH₂CH₂O)₃H CH N 180 OCH₃ O(CH₂CH₂O)₃H CH N 181 Br O(CH₂CH₂O)₃H CH N 182 CF₃ O(CH₂CH₂O)₃H CH N 183 H O(CH₂CH₂O)₆H CH N 184 Cl O(CH₂CH₂O)₆H CH N 185 F O(CH₂CH₂O)₆H CH N 186 CH₃ O(CH₂CH₂O)₆H CH N 187 OCH₃ O(CH₂CH₂O)₆H CH N 188 Br O(CH₂CH₂O)₆H CH N 189 CF₃ O(CH₂CH₂O)₆H CH N 190 H C(NH)NH₂ N N 191 Cl C(NH)NH₂ N N 192 F C(NH)NH₂ N N 193 CH₃ C(NH)NH₂ N N 194 OCH₃ C(NH)NH₂ N N 195 Br C(NH)NH₂ N N 196 CF₃ C(NH)NH₂ N N 197 Cl OCH₂C(NH)NH₂ N N 198 H OCH₂C(NH)NH₂ N N 199 F OCH₂C(NH)NH₂ N N 200 CH₃ OCH₂C(NH)NH₂ N N 201 OCH₃ OCH₂C(NH)NH₂ N N 202 Br OCH₂C(NH)NH₂ N N 203 CF₃ OCH₂C(NH)NH₂ N N 204 H CH₂C(NH)NH₂ N N 205 Cl CH₂C(NH)NH₂ N N 206 F CH₂C(NH)NH₂ N N 207 CH₃ CH₂C(NH)NH₂ N N 208 OCH₃ CH₂C(NH)NH₂ N N 209 Br CH₂C(NH)NH₂ N N 210 CF₃ CH₂C(NH)NH₂ N N 211 H tetrazole N N 212 Cl tetrazole N N 213 F tetrazole N N 214 CH₃ tetrazole N N 215 OCH₃ tetrazole N N 216 Br tetrazole N N 217 CF₃ tetrazole N N 218 H OCH₂-tetrazole N N 219 Cl OCH₂-tetrazole N N 220 F OCH₂-tetrazole N N 221 CH₃ OCH₂-tetrazole N N 222 OCH₃ OCH₂-tetrazole N N 223 Br OCH₂-tetrazole N N 224 CF₃ OCH₂-tetrazole N N 225 H O(CH₂CH₂O)₃Et N N 226 Cl O(CH₂CH₂O)₃Et N N 227 F O(CH₂CH₂O)₃Et N N 228 CH₃ O(CH₂CH₂O)₃Et N N 229 OCH₃ O(CH₂CH₂O)₃Et N N 230 Br O(CH₂CH₂O)₃Et N N 231 CF₃ O(CH₂CH₂O)₃Et N N 232 H O(CH₂CH₂O)₆Et N N 233 Cl O(CH₂CH₂O)₆Et N N 234 F O(CH₂CH₂O)₆Et N N 235 CH₃ O(CH₂CH₂O)₆Et N N 236 OCH₃ O(CH₂CH₂O)₆Et N N 237 Br O(CH₂CH₂O)₆Et N N 238 CF₃ O(CH₂CH₂O)₆Et N N 239 H O(CH₂CH₂O)₃H N N 240 Cl O(CH₂CH₂O)₃H N N 241 F O(CH₂CH₂O)₃H N N 242 CH₃ O(CH₂CH₂O)₃H N N 243 OCH₃ O(CH₂CH₂O)₃H N N 244 Br O(CH₂CH₂O)₃H N N 245 CF₃ O(CH₂CH₂O)₃H N N 246 H O(CH₂CH₂O)₆H N N 247 Cl O(CH₂CH₂O)₆H N N 248 F O(CH₂CH₂O)₆H N N 249 CH₃ O(CH₂CH₂O)₆H N N 250 OCH₃ O(CH₂CH₂O)₆H N N 251 Br O(CH₂CH₂O)₆H N N 252 CF₃ O(CH₂CH₂O)₆H N N 253 H CONHCHCH₃CO₂H CH CH 254 Cl CONHCHCH₃CO₂H CH CH 255 F CONHCHCH₃CO₂H CH CH 256 CH₃ CONHCHCH₃CO₂H CH CH 257 OCH₃ CONHCHCH₃CO₂H CH CH 258 Br CONHCHCH₃CO₂H CH CH 259 CF₃ CONHCHCH₃CO₂H CH CH 260 H CONHCHCH₃CONH₂ CH CH 261 Cl CONHCHCH₃CONH₂ CH CH 262 F CONHCHCH₃CONH₂ CH CH 263 CH₃ CONHCHCH₃CONH₂ CH CH 264 OCH₃ CONHCHCH₃CONH₂ CH CH 265 Br CONHCHCH₃CONH₂ CH CH 266 CF₃ CONHCHCH₃CONH₂ CH CH 267 H CONHCHCH₃CONHCH₂CONH₂ CH CH 268 Cl CONHCHCH₃CONHCH₂CONH₂ CH CH 269 F CONHCHCH₃CONHCH₂CONH₂ CH CH 270 CH₃ CONHCHCH₃CONHCH₂CONH₂ CH CH 271 OCH₃ CONHCHCH₃CONHCH₂CONH₂ CH CH 272 Br CONHCHCH₃CONHCH₂CONH₂ CH CH 273 CF₃ CONHCHCH₃CONHCH₂CONH₂ CH CH 274 H CONHCHCH₃CO₂H CH N 275 Cl CONHCHCH₃CO₂H CH N 276 F CONHCHCH₃CO₂H CH N 277 CH₃ CONHCHCH₃CO₂H CH N 278 OCH₃ CONHCHCH₃CO₂H CH N 279 Br CONHCHCH₃CO₂H CH N 280 CF₃ CONHCHCH₃CO₂H CH N 281 H CONHCHCH₃CONH₂ CH N 282 Cl CONHCHCH₃CONH₂ CH N 283 F CONHCHCH₃CONH₂ CH N 284 CH₃ CONHCHCH₃CONH₂ CH N 285 OCH₃ CONHCHCH₃CONH₂ CH N 286 Br CONHCHCH₃CONH₂ CH N 287 CF₃ CONHCHCH₃CONH₂ CH N 288 H CONHCHCH₃CONHCH₂CONH₂ CH N 289 Cl CONHCHCH₃CONHCH₂CONH₂ CH N 290 F CONHCHCH₃CONHCH₂CONH₂ CH N 291 CH₃ CONHCHCH₃CONHCH₂CONH₂ CH N 292 OCH₃ CONHCHCH₃CONHCH₂CONH₂ CH N 293 Br CONHCHCH₃CONHCH₂CONH₂ CH N 294 CF₃ CONHCHCH₃CONHCH₂CONH₂ CH N 295 H CONHCHCH₃CO₂H N CH 296 Cl CONHCHCH₃CO₂H N CH 297 F CONHCHCH₃CO₂H N CH 298 CH₃ CONHCHCH₃CO₂H N CH 299 OCH₃ CONHCHCH₃CO₂H N CH 300 Br CONHCHCH₃CO₂H N CH 301 CF₃ CONHCHCH₃CO₂H N CH 302 H CONHCHCH₃CONH₂ N CH 303 Cl CONHCHCH₃CONH₂ N CH 304 F CONHCHCH₃CONH₂ N CH 305 CH₃ CONHCHCH₃CONH₂ N CH 306 OCH₃ CONHCHCH₃CONH₂ N CH 307 Br CONHCHCH₃CONH₂ N CH 308 CF₃ CONHCHCH₃CONH₂ N CH 309 H CONHCHCH₃CONHCH₂CONH₂ N CH 310 Cl CONHCHCH₃CONHCH₂CONH₂ N CH 311 F CONHCHCH₃CONHCH₂CONH₂ N CH 312 CH₃ CONHCHCH₃CONHCH₂CONH₂ N CH 313 OCH₃ CONHCHCH₃CONHCH₂CONH₂ N CH 314 Br CONHCHCH₃CONHCH₂CONH₂ N CH 315 CF₃ CONHCHCH₃CONHCH₂CONH₂ N CH 316 H CONHCHCH₃CO₂H N N 317 Cl CONHCHCH₃CO₂H N N 318 F CONHCHCH₃CO₂H N N 319 CH₃ CONHCHCH₃CO₂H N N 320 OCH₃ CONHCHCH₃CO₂H N N 321 Br CONHCHCH₃CO₂H N N 322 CF₃ CONHCHCH₃CO₂H N N 323 H CONHCHCH₃CONH₂ N N 324 Cl CONHCHCH₃CONH₂ N N 325 F CONHCHCH₃CONH₂ N N 326 CH₃ CONHCHCH₃CONH₂ N N 327 OCH₃ CONHCHCH₃CONH₂ N N 328 Br CONHCHCH₃CONH₂ N N 329 CF₃ CONHCHCH₃CONH₂ N N 330 H CONHCHCH₃CONHCH₂CONH₂ N N 331 Cl CONHCHCH₃CONHCH₂CONH₂ N N 332 F CONHCHCH₃CONHCH₂CONH₂ N N 333 CH₃ CONHCHCH₃CONHCH₂CONH₂ N N 334 OCH₃ CONHCHCH₃CONHCH₂CONH₂ N N 335 Br CONHCHCH₃CONHCH₂CONH₂ N N 336 CF₃ CONHCHCH₃CONHCH₂CONH₂ N N

TABLE 2 B

Examples 1-336 of Table 2 correspond to Examples 1-336 of Table 1, except that they are based on formula B instead of formula A.

TABLE 3 C

Number X^(a) Y 1 H C(NH)NH₂ 2 Cl C(NH)NH₂ 3 F C(NH)NH₂ 4 CF₃ C(NH)NH₂ 5 CN C(NH)NH₂ 6 Br C(NH)NH₂ 7 H CO₂Et 8 Cl CO₂Et 9 F CO₂Et 10 CF₃ CO₂Et 11 CN CO₂Et 12 Br CO₂Et 13 H CO₂H 14 Cl CO₂H 15 F CO₂H 16 CF₃ CO₂H 17 CN CO₂H 18 Br CO₂H 19 H CONH₂ 20 Cl CONH₂ 21 F CONH₂ 22 CF₃ CONH₂ 23 CN CONH₂ 24 Br CONH₂ 25 H tetrazole 26 Cl tetrazole 27 F tetrazole 28 CF₃ tetrazole 29 CN tetrazole 30 Br tetrazole 31 H OCH₂C(NH)NH₂ 32 Cl OCH₂C(NH)NH₂ 33 F OCH₂C(NH)NH₂ 34 CF₃ OCH₂C(NH)NH₂ 35 CN OCH₂C(NH)NH₂ 36 Br OCH₂C(NH)NH₂ 37 H OCH₂CO₂Et 38 Cl OCH₂CO₂Et 39 F OCH₂CO₂Et 40 CF₃ OCH₂CO₂Et 41 CN OCH₂CO₂Et 42 Br OCH₂CO₂Et 43 H OCH₂CO₂H 44 Cl OCH₂CO₂H 45 F OCH₂CO₂H 46 CF₃ OCH₂CO₂H 47 CN OCH₂CO₂H 48 Br OCH₂CO₂H 49 H OCH₂CONH₂ 50 Cl OCH₂CONH₂ 51 F OCH₂CONH₂ 52 CF₃ OCH₂CONH₂ 53 CN OCH₂CONH₂ 54 Br OCH₂CONH₂ 55 H OCH₂tetrazole 56 Cl OCH₂tetrazole 57 F OCH₂tetrazole 58 CF₃ OCH₂tetrazole 59 CN OCH₂tetrazole 60 Br OCH₂tetrazole 61 H NHSO₂CH₃ 62 Cl NHSO₂CH₃ 63 F NHSO₂CH₃ 64 CF₃ NHSO₂CH₃ 65 CN NHSO₂CH₃ 66 Br NHSO₂CH₃ 67 H NHCOCH₂CO₂CH₃ 68 Cl NHCOCH₂CO₂CH₃ 69 F NHCOCH₂CO₂CH₃ 70 CF₃ NHCOCH₂CO₂CH₃ 71 CN NHCOCH₂CO₂CH₃ 72 Br NHCOCH₂CO₂CH₃ 73 H NHCOCH₂CO₂H 74 Cl NHCOCH₂CO₂H 75 F NHCOCH₂CO₂H 76 CF₃ NHCOCH₂CO₂H 77 CN NHCOCH₂CO₂H 78 Br NHCOCH₂CO₂H 79 H NHCOCH₂CONH₂ 80 Cl NHCOCH₂CONH₂ 81 F NHCOCH₂CONH₂ 82 CF₃ NHCOCH₂CONH₂ 83 CN NHCOCH₂CONH₂ 84 Br NHCOCH₂CONH₂ 85 H NHCH₂CO₂CH₃ 86 Cl NHCH₂CO₂CH₃ 87 F NHCH₂CO₂CH₃ 88 CF₃ NHCH₂CO₂CH₃ 89 CN NHCH₂CO₂CH₃ 90 Br NHCH₂CO₂CH₃ 91 H NHCH₂CO₂H 92 Cl NHCH₂CO₂H 93 F NHCH₂CO₂H 94 CF₃ NHCH₂CO₂H 95 CN NHCH₂CO₂H 96 Br NHCH₂CO₂H 97 H NHCH₂CONH₂ 98 Cl NHCH₂CONH₂ 99 F NHCH₂CONH₂ 100 CF₃ NHCH₂CONH₂ 101 CN NHCH₂CONH₂ 102 Br NHCH₂CONH₂ 103 H CONHCH₂CO₂Et 104 Cl CONHCH₂CO₂Et 105 F CONHCH₂CO₂Et 106 CF₃ CONHCH₂CO₂Et 107 CN CONHCH₂CO₂Et 108 Br CONHCH₂CO₂Et 109 H CONHCH₂CO₂H 110 Cl CONHCH₂CO₂H 111 F CONHCH₂CO₂H 112 CF₃ CONHCH₂CO₂H 113 CN CONHCH₂CO₂H 114 Br CONHCH₂CO₂H 115 H CONHCH₂CONH₂ 116 Cl CONHCH₂CONH₂ 117 F CONHCH₂CONH₂ 118 CF₃ CONHCH₂CONH₂ 119 CN CONHCH₂CONH₂ 120 Br CONHCH₂CONH₂ 121 H O(CH₂CH₂O)₂H 122 Cl O(CH₂CH₂O)₂H 123 F O(CH₂CH₂O)₂H 124 CF₃ O(CH₂CH₂O)₂H 125 CN O(CH₂CH₂O)₂H 126 Br O(CH₂CH₂O)₂H 127 H O(CH₂CH₂O)₄H 128 Cl O(CH₂CH₂O)₄H 129 F O(CH₂CH₂O)₄H 130 CF₃ O(CH₂CH₂O)₄H 131 CN O(CH₂CH₂O)₄H 132 Br O(CH₂CH₂O)₄H 133 H O(CH₂CH₂O)₆H 134 Cl O(CH₂CH₂O)₆H 135 F O(CH₂CH₂O)₆H 136 CF₃ O(CH₂CH₂O)₆H 137 CN O(CH₂CH₂O)₆H 138 Br O(CH₂CH₂O)₆H 139 H CONHCH₂CONHCHCH₃CONH₂ 140 Cl CONHCH₂CONHCHCH₃CONH₂ 141 F CONHCH₂CONHCHCH₃CONH₂ 142 CF₃ CONHCH₂CONHCHCH₃CONH₂ 143 CN CONHCH₂CONHCHCH₃CONH₂ 144 Br CONHCH₂CONHCHCH₃CONH₂

TABLE 4 D

Examples 1-144 of Table 4 correspond to Examples 1-144 of Table 3, except that they are based on formula D instead of formula C.

TABLE 5 E

Examples 1-144 of Table 5 correspond to Examples 1-144 of Table 3, except that they are based on formula E instead of formula C.

TABLE 6 F

Examples 1-144 of Table 6 correspond to Examples 1-144 of Table 3, except that they are based on formula F instead of formula C.

TABLE 7 G

Examples 1-144 of Table 7 correspond to Examples 1-144 of Table 3, except that they are based on formula G instead of formula C.

Numerous modifications and variations of the present invention are possible in light of the above teachings. It is therefore to be understood that within the scope of the appended claims, the invention may be practiced otherwise that as specifically described herein. 

1. A compound of Formula I or a stereoisomer or pharmaceutically acceptable salt thereof:

wherein: R₁ and R₂ are independently aryl or heteroaryl, wherein each aryl or heteroaryl is substituted with 0-3 substituents independently selected from X and X′; X at each occurrence is independently selected from halogen, C₁₋₆ alkyl, CF₃, CN, OC₁₋₆-alkyl, (CH₂)_(m)C(NH)NR₂, O(CH₂)_(n)CO₂R, O(CH₂)_(n)CONR₂, O(CH₂)_(n)C(NH)NR₂, NR(CH₂)_(n)CO₂R, O(CH₂)_(n)C₆H₄(CH₂)_(m)CO₂R, NR(CH₂)_(n)C₆H₄(CH₂)_(m)CO₂R, O(CH₂)_(n)C₆H₄O(CH₂)_(n)CO₂R, NR(CH₂)_(n)C₆H₄O(CH₂)_(n)CO₂R, O(CH₂)_(n)C₆H₄(CH₂)_(m)CONR₂, NR(CH₂)_(n)C₆H₄(CH₂)_(m)CONR₂, O(CH₂)_(n)C₆H₄O(CH₂)_(n)CONR₂, NR(CH₂)_(n)C₆H₄O(CH₂)_(n)CONR₂, PO₃R₂, SO₃R, O(CH₂CH₂O)_(q)R, NR(CH₂CH₂O)_(q)R, (CH₂)_(m)tetrazole, O(CH₂)_(n)-tetrazole, CONR(CH₂)_(m)CHA(CH₂)_(m)CO₂R, NR(CH₂)_(m)CO₂R, NR(CH₂)_(m)CONR₂, CONR(CH₂)_(m)CHA(CH₂)_(m)CONR₂, CONR(CH₂)_(m)CHA(CH₂)_(m)CONR(CH₂)_(m)CHA(CH₂)_(m)CONR₂, CONR(CH₂)_(m)CHA(CH₂)_(m)CONR(CH₂)_(m)CHA(CH₂)_(m)CONR(CH₂)_(m)CHA(CH₂)_(m)CON R₂, CONR(CH₂)_(m)CHA(CH₂)_(m)CONR(CH₂)_(m)CHA(CH₂)_(m)CO₂R, and CONR(CH₂)_(m)CHA(CH₂)_(m)CONR(CH₂)_(m)CHA(CH₂)_(m)CONR(CH₂)_(m)CHA(CH₂)_(m)CO₂R; X′ at each occurrence is independently selected from halogen, C₁₋₄-alkyl, CF₃, CN, O—C₁₋₆ alkyl, NO₂, O(CH₂CH₂O)_(q)R, and NR(CH₂CH₂O)_(q)R; Y at each occurrence is independently selected from H, halogen, C₁₋₆ alkyl, CF₃, CN, (CH₂)_(m)C(NH)NR₂, NHCOR, NHSO₂R, (CH₂)_(m)CO₂R, (CH₂)_(m)CONR₂, NRCONR₂, O(CH₂)_(n)CO₂R, O(CH₂)_(n)CONR₂, NRC(O)(CH₂)_(n)CO₂R, NRC(O)(CH₂)_(n)CONR₂, O(CH₂)_(n)C(NH)NR₂, O(CH₂)_(n)C₆H₄(CH₂)_(m)CO₂R, NR(CH₂)_(n)C₆H₄(CH₂)_(m)CO₂R, O(CH₂)_(n)C₆H₄O(CH₂)_(n)CO₂R, NR(CH₂)_(n)C₆H₄O(CH₂)_(n)CO₂R, O(CH₂)_(n)C₆H₄(CH₂)_(m)CONR₂, NR(CH₂)_(n)C₆H₄(CH₂)_(m)CONR₂, O(CH₂)_(n)C₆H₄O(CH₂)_(n)CONR₂, NR(CH₂)_(n)C₆H₄O(CH₂)_(n)CONR₂, PO₃R₂, SO₃R, O(CH₂CH₂O)_(q)R, NR(CH₂CH₂O)_(q)R, (CH₂)_(m)NH(C═NHCN)NHR′, (CH₂)_(m)NH(C═CHNO₂)NHR′, (CH₂)_(m)tetrazole, O(CH₂)_(n)tetrazole, CONR(CH₂)_(m)CHA(CH₂)_(m)CO₂R, NR(CH₂)_(m)CO₂R, NR(CH₂)_(m)CONR₂, CONR(CH₂)_(m)CHA(CH₂)_(m)CONR₂, CONR(CH₂)_(m)CHA(CH₂)_(m)CONR(CH₂)_(m)CHA(CH₂)_(m)CONR₂, CONR(CH₂)_(m)CHA(CH₂)_(m)CONR(CH₂)_(m)CHA(CH₂)_(m)CONR(CH₂)_(m)CHA(CH₂)_(m)CON R₂, CONR(CH₂)_(m)CHA(CH₂)_(m)CONR(CH₂)_(m)CHA(CH₂)_(m)CO₂R, and CONR(CH₂)_(m)CHA(CH₂)_(m)CONR(CH₂)_(m)CHA(CH₂)_(m)CONR(CH₂)_(m)CHA(CH₂)_(m)CO₂R; Z, Z′, and Z″ are independently N or CY; A is selected from H, OH, C₁₋₆ alkyl, (CH₂)_(m)C₃₋₆-cycloalkyl, CH₂OH, CH(CH₃)OH, C(CH₃)₂OH, (CH₂)_(n)CONHR and (CH₂)_(m)-phenyl, wherein the phenyl is substituted with 0-3 groups selected from H, C₁₋₄ alkyl, halogen, CF₃, O—C₁₋₄ alkyl, NO₂, NH₂, NHCONHR, NHSO₂CH₃, CONHR, and NHCO₂R′; Q is selected from H, C₁₋₆ alkyl, (CH₂)_(m)CN, (CH₂)_(m)C(NR)NH₂, (CH₂)_(m)-tetrazole, (CH₂)_(m)C(NR)NH₂, and (CH₂)_(m)O(CH₂CH₂O)_(q)R; R at each occurrence is independently selected from H and C₁₋₆ alkyl; R′ at each occurrence is independently C₁₋₆ alkyl; m at each occurrence is independently selected from 0, 1, 2, 3, and 4; n at each occurrence is independently selected from 1, 2, 3, and 4; and, q at each occurrence is independently selected from 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, and 12; provided that: (a) Q is other than H and alkyl; (b) X is other than H, halogen, C₁₋₆ alkyl, CF₃, CN, O—C₁₋₆ alkyl, (CH₂)_(m)tetrazole, O(CH₂)_(n)tetrazole, NRCO₂R, and NRCONR₂; and/or (c) Y is other than H, halogen, C₁₋₆ alkyl, CF₃, and CN.
 2. A compound of claim 1, wherein: R₁ and R₂ are independently phenyl or 6-membered heteroaryl, wherein each phenyl or heteroaryl is substituted with 0-2 substituents independently selected from X and X′; X at each occurrence is independently selected from halogen, C₁₋₆ alkyl, CF₃, CN, OC₁₋₆-alkyl, (CH₂)_(m)C(NH)NR₂, O(CH₂)_(n)CO₂R, O(CH₂)_(n)CONR₂, O(CH₂)_(n)C(NH)NR₂, NR(CH₂)_(n)CO₂R, O(CH₂)_(n)C₆H₄(CH₂)_(m)CO₂R, NR(CH₂)_(n)C₆H₄(CH₂)_(m)CO₂R, O(CH₂)_(n)C₆H₄O(CH₂)_(n)CO₂R, NR(CH₂)_(n)C₆H₄O(CH₂)_(n)CO₂R, O(CH₂)_(n)C₆H₄(CH₂)_(m)CONR₂, NR(CH₂)_(n)C₆H₄(CH₂)_(m)CONR₂, O(CH₂)_(n)C₆H₄O(CH₂)_(n)CONR₂, NR(CH₂)_(n)C₆H₄O(CH₂)_(n)CONR₂, PO₃R₂, SO₃R, O(CH₂CH₂O)_(q)R, NR(CH₂CH₂O)_(q)R, (CH₂)_(m)tetrazole, O(CH₂)_(n)-tetrazole, CONR(CH₂)_(m)CHA(CH₂)_(m)CO₂R, NR(CH₂)_(m)CO₂R, NH(CH₂)_(m)CONH₂; CONH(CH₂)_(m)CHA(CH₂)_(m)CONR₂, CONH(CH₂)_(m)CHA(CH₂)_(m)CONH(CH₂)_(m)CHA(CH₂)_(m)CONR₂, CONH(CH₂)_(m)CHA(CH₂)_(m)CONH(CH₂)_(m)CHA(CH₂)_(m)CONH(CH₂)_(m)CHA(CH₂)_(m)CON R₂, CONH(CH₂)_(m)CHA(CH₂)_(m)CONH(CH₂)_(m)CHA(CH₂)_(m)CO₂R, and CONR(CH₂)_(m)CHA(CH₂)_(m)CONH(CH₂)_(m)CHA(CH₂)_(m)CONH(CH₂)_(m)CHA(CH₂)_(m)CO₂R; X′ at each occurrence is independently selected from halogen, C₁₋₆ alkyl, CF₃, CN, O—C₁₋₆ alkyl, and NO₂; Y at each occurrence is independently selected from H, halogen, C₁₋₆ alkyl, CF₃, CN, O(CH₂CH₂O)_(q)R, and NR(CH₂CH₂O)_(q)R; Z, Z′, and Z″ are independently N or CY; A is selected from H, OH, C₁₋₄ alkyl, (CH₂)_(m)C₃₋₆-cycloalkyl, CH₂OH, CH(CH₃)OH, C(CH₃)₂OH(CH₂)_(n)CONHR and (CH₂)_(m)-phenyl, wherein the phenyl is substituted with 0-3 groups selected from H, C₁₋₄ alkyl, Cl, F, CF₃, O—C₁₋₄ alkyl, NO₂, NH₂, NHCONHR, NHSO₂CH₃, CONHR, and NHCO₂R′; Q is selected from H, C₁₋₆ alkyl, (CH₂)_(m)CN, and (CH₂)_(m)O(CH₂CH₂O)_(q)R; R at each occurrence is independently selected from H and C₁₋₆ alkyl; R′ at each occurrence is independently selected from C₁₋₄ alkyl; m at each occurrence is independently selected from 0, 1, 2, and 3; n at each occurrence is independently selected from 1, 2, and 3; and, or a stereoisomer or pharmaceutically acceptable salt thereof; provided that: (a) Q is other than H and alkyl; (b) X is other than H, halogen, C₁₋₆ alkyl, CF₃, CN, O—C₁₋₆ alkyl, (CH₂)_(m)tetrazole, O(CH₂)_(n)tetrazole, NRCO₂R, and NRCONR₂; and/or (c) Y is other than H, halogen, C₁₋₆ alkyl, CF₃, and CN.
 3. A compound of claim 1, wherein: R₁ and R₂ are independently phenyl or 6-membered heteroaryl, wherein each phenyl or heteroaryl is substituted with 0-2 substituents independently selected from X and X′; X at each occurrence is independently selected from C₁₋₄ alkyl, halogen, CF₃, O—C₁₋₆ alkyl, CN, NO₂, O(CH₂CH₂O)_(q)R, and NR(CH₂CH₂O)_(q)R; X′ at each occurrence is independently selected from halogen, C₁₋₄ alkyl, CF₃, CN, O—C₁₋₆ alkyl, and NO₂; Y at each occurrence is independently selected from H, halogen, C₁₋₆ alkyl, CF₃, CN, (CH₂)_(m)C(NH)NR₂, NHCOR, NHSO₂R, (CH₂)_(m)CO₂R, (CH₂)_(m)CONR₂, NHRCONR, O(CH₂)_(n)CO₂R, O(CH₂)_(n)CONR₂, O(CH₂)_(n)C(NH)NR₂, NRC(O)(CH₂)_(n)CO₂R, NRC(O)(CH₂)_(n)CONR₂, O(CH₂)_(n)C₆H₄(CH₂)_(m)CO₂R, NR(CH₂)_(n)C₆H₄(CH₂)_(m)CO₂R, O(CH₂)_(n)C₆H₄O(CH₂)_(n)CO₂R, NR(CH₂)_(n)C₆H₄O(CH₂)_(n)CO₂R, O(CH₂)_(n)C₆H₄(CH₂)_(m)CONR₂, NR(CH₂)_(n)C₆H₄(CH₂)_(m)CONR₂, O(CH₂)_(n)C₆H₄O(CH₂)_(n)CONR₂, NR(CH₂)_(n)C₆H₄O(CH₂)_(n)CONR₂, PO₃R₂, SO₃R, O(CH₂CH₂O)_(q)R, NR(CH₂CH₂O)_(q)R, (CH₂)_(m)—NH(C═NHCN)NHR′, (CH₂)_(m)NH(C═CHNO₂)NHR′, (CH₂)_(m)tetrazole, O(CH₂)_(n)tetrazole, CONH(CH₂)_(m)CHA(CH₂)_(m)CO₂R, NR(CH₂)_(m)CO₂R, NR(CH₂)_(m)CONH₂, CONH(CH₂)_(m)CHA(CH₂)_(m)CONR₂, CONH(CH₂)_(m)CHA(CH₂)_(m)CONH(CH₂)_(m)CHA(CH₂)_(m)CONR₂, CONH(CH₂)_(m)CHA(CH₂)_(m)CONH(CH₂)_(m)CHA(CH₂)_(m)CONH(CH₂)_(m)CHA(CH₂)_(m)CON R₂, CONH(CH₂)_(m)CHA(CH₂)_(m)CONH(CH₂)_(m)CHA(CH₂)_(m)CO₂R, and CONH(CH₂)_(m)CHA(CH₂)_(m)CONH(CH₂)_(m)CHA(CH₂)_(m)CONH(CH₂)_(m)CHA(CH₂)_(m)CO₂R; Z, Z′, and Z″ are independently N or CY; A is selected from H, OH, C₁₋₄ alkyl, (CH₂)_(m)C₃₋₆-cycloalkyl, CH₂OH, CH(CH₃)OH, C(CH₃)₂OH(CH₂)_(n)CONR₂ and (CH₂)_(m)-phenyl, wherein the phenyl is substituted with 0-3 groups selected from H, C₁₋₄ alkyl, Cl, F, CF₃, O—C₁₋₄ alkyl, NO₂, NH₂, NHCONHR, NHSO₂CH₃, CONHR, and NHCO₂R′; Q is selected from H and C₁₋₄ alkyl; R at each occurrence is independently selected from H and C₁₋₄ alkyl; R′ at each occurrence is independently selected from C₁₋₄ alkyl; m at each occurrence is independently selected from 0, 1, 2, and 3; and, n at each occurrence is independently selected from 1, 2, and 3; or a stereoisomer or pharmaceutically acceptable salt thereof; provided that: (a) Q is other than H and alkyl; (b) X is other than H, halogen, C₁₋₆ alkyl, CF₃, CN, O—C₁₋₆ alkyl, (CH₂)_(m)tetrazole, O(CH₂)_(n)tetrazole, NRCO₂R, and NRCONR₂; and/or (c) Y is other than H, halogen, C₁₋₆ alkyl, CF₃, and CN.
 4. A compound of claim 1, wherein: R₁ and R₂ are independently phenyl or 6-membered heteroaryl, wherein each phenyl or heteroaryl is substituted with 0-2 substituents independently selected from X and X′; X at each occurrence is independently selected from halogen, C₁₋₄-alkyl, CF₃, CN, O—C₁₋₆ alkyl, NO₂, O(CH₂CH₂O)_(q)R, and NR(CH₂CH₂O)_(q)R; X′ at each occurrence is independently selected from halogen, C₁₋₄-alkyl, CF₃, CN, O—C₁₋₆ alkyl, NO₂, O(CH₂CH₂O)_(q)R, and NR(CH₂CH₂O)_(q)R; Y is selected from H, halogen, C₁₋₄ alkyl, CF₃, and CN; Z, Z′, and Z″ are independently N or CH; Q is selected from (CH₂)_(m)C(NH)NH₂, (CH₂)_(m)-tetrazole, and (CH₂)_(m)O(CH₂CH₂O)_(q)R; R at each occurrence is independently selected from H and C₁₋₄ alkyl; m at each occurrence is independently selected from 0, 1, 2, and 3; and, n at each occurrence is independently selected from 1, 2, and 3; or a stereoisomer or pharmaceutically acceptable salt thereof.
 5. A compound of claim 1, wherein the compound is selected from a compound of formula Ia-Id.

or a stereoisomer or pharmaceutically acceptable salt thereof.
 6. A compound of claim 5, wherein the compound is selected from a compound of formula II.

or a stereoisomer or pharmaceutically acceptable salt thereof.
 7. A compound of claim 6, wherein the compound is selected from a compound of formula IIa:

or a stereoisomer or pharmaceutically acceptable salt thereof.
 8. A compound of claim 5, wherein the compound is selected from a compound of formula III:

or a stereoisomer or pharmaceutically acceptable salt thereof.
 9. A compound of claim 8, wherein the compound is selected from a compound of formula IIIa:

or a stereoisomer or pharmaceutically acceptable salt thereof.
 10. A compound of claim 2, wherein the compound is selected from a compound of formula Ia-IIIa.

or a stereoisomer or pharmaceutically acceptable salt thereof.
 11. A compound of claim 3, wherein the compound is selected from a compound of formula Ia-IIIa.

or a stereoisomer or pharmaceutically acceptable salt thereof.
 12. A compound of claim 1, wherein the compound is selected from the compounds of Table 1, 2, 3, 4, 5, 6, and 7 or a stereoisomer or a pharmaceutically acceptable salt thereof.
 13. A pharmaceutical composition, comprising: a compound according to claim 1 and a pharmaceutically acceptable carrier.
 14. A method of treating a disease, comprising: administering to a mammal in need thereof a therapeutically effective amount of a compound of according to claim 1, wherein the disease is selected from obesity, diabetes, cardiometabolic disorders, and a combination thereof.
 15. A method of treating a co-morbidity of obesity, comprising: administering to a mammal in need thereof a therapeutically effective amount of a compound of claim
 1. 16. A method of treating a disease, comprising: administering to a mammal in need thereof a therapeutically effective amount of a. a compound of according to claim 1, and b. a second therapeutic agent; wherein the disease is selected from obesity, diabetes, cardiometabolic disorders, and a combination thereof and the second therapeutic agent is useful for treating the disease. 